Provider Demographics
NPI:1134727530
Name:FIELDS, RIKEE MARTINA (NP-C)
Entity type:Individual
Prefix:
First Name:RIKEE
Middle Name:MARTINA
Last Name:FIELDS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E 300N RD
Mailing Address - Street 2:
Mailing Address - City:GIBSON CITY
Mailing Address - State:IL
Mailing Address - Zip Code:60936-7134
Mailing Address - Country:US
Mailing Address - Phone:217-495-0971
Mailing Address - Fax:
Practice Address - Street 1:3 DOCTORS PARK
Practice Address - Street 2:
Practice Address - City:GIBSON CITY
Practice Address - State:IL
Practice Address - Zip Code:60936-2000
Practice Address - Country:US
Practice Address - Phone:217-784-4030
Practice Address - Fax:217-784-4405
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily