CHRISTINA FULTZ RICKENBACK APRN NPI 1104831460

NPI Information

  • NPI: 1104831460
  • Provider Name: CHRISTINA FULTZ RICKENBACK, APRN
  • Classification: Nurse Practitioner - 363LP0200X
  • Specialization: Pediatrics
  • Entity Type: Individual
  • Address: ONE WILDWOOD MEDICAL CENTER
    ESSEX, CT
    ZIP 06426
  • Phone: (860) 767-0168

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NPI Details

Christina Fultz Rickenback, APRN is a pediatrics nurse practitioner in Essex, CT. Christina Fultz Rickenback, APRN NPI is 1104831460. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

ONE WILDWOOD MEDICAL CENTER
ESSEX, CT
ZIP 06426
Phone: (860) 767-0168
Fax: (860) 767-1803

The enumeration date for this NPI number is 7/29/2006 and was last updated on 8/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatrics000028CONNECTICUTYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500000833MEDICARE ID-TYPE UNSPECIFIED
2P11996MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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