Provider Demographics
NPI:1083254361
Name:RICE, DESIREE KATHERINE (MSN APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:KATHERINE
Last Name:RICE
Suffix:
Gender:F
Credentials:MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 IMPERIAL PALM DR
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2475
Mailing Address - Country:US
Mailing Address - Phone:321-689-3595
Mailing Address - Fax:
Practice Address - Street 1:1705 IMPERIAL PALM DR
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2475
Practice Address - Country:US
Practice Address - Phone:321-689-3595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily