Provider Demographics
NPI:1083903801
Name:RICE, KATHRYN LORETTA (RN, CNOR)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:LORETTA
Last Name:RICE
Suffix:
Gender:F
Credentials:RN, CNOR
Other - Prefix:MS
Other - First Name:KATHRYN
Other - Middle Name:LORETTA
Other - Last Name:LITTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:631 PROFESSIONAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-3371
Mailing Address - Country:US
Mailing Address - Phone:770-962-2640
Mailing Address - Fax:
Practice Address - Street 1:631 PROFESSIONAL DR STE 300
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-3371
Practice Address - Country:US
Practice Address - Phone:770-962-2640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN087860163WA2000X, 163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care