Active NPI
Tiffany Elaine Rickett, RN BSN
- Registered Nurse
- Berkley, MI
National Provider Identifier
1639546856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 4704276787
- Practice address
- 2766 W 11 Mile Rd
Berkley, MI 48072-3033 - Phone
- (248) 542-2424
- NPI assigned
- Aug 24, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 4704276787 | MI | Primary |
Addresses
Primary practice location
2766 W 11 Mile Rd
Berkley, MI 48072-3033
Mailing address
1195 N Wildwood St
Westland, MI 48185-3503
Phone (734) 620-8873
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704276787 | MI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440374400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440374400000",
"number": "1639546856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1195 N WILDWOOD ST",
"city": "WESTLAND",
"state": "MI",
"postal_code": "481853503",
"telephone_number": "734-620-8873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2766 W 11 MILE RD",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480723033",
"telephone_number": "248-542-2424"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RICKETT",
"first_name": "TIFFANY",
"middle_name": "ELAINE",
"credential": "RN BSN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-24",
"last_updated": "2015-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MI",
"license": "4704276787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkley, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.