Provider Demographics
NPI:1528941887
Name:IKERI, RICHARD CHIMA SR
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:CHIMA
Last Name:IKERI
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2703 SNOWDRIFT CIR E
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:MN
Mailing Address - Zip Code:55119-5993
Mailing Address - Country:US
Mailing Address - Phone:651-341-9099
Mailing Address - Fax:651-414-9102
Practice Address - Street 1:425 LAURIE RD E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55117-1840
Practice Address - Country:US
Practice Address - Phone:651-341-9099
Practice Address - Fax:651-340-9099
Is Sole Proprietor?:No
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide