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RICKY ALAN CLIETT

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1295308088

Individual Registrant:
 RICKY ALAN CLIETT 
Gender: M
Sole Proprietor

Location and contact information for practice:
144 E OAK ST  MC RAE, GA 31055-4338 US
Tel: 229-860-1295  Fax: --

Contact information for business:
542 FRIENDSHIP CHURCH RD  JACKSONVILLE, GA 31544-1836 US
Tel: --  Fax: --

Registration Information:
NPI: 1295308088
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
GARN274538

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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