Provider Demographics
NPI:1255841250
Name:RICE, JOANNA M (RN)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:M
Last Name:RICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:JOANN
Other - Middle Name:
Other - Last Name:HATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:VISN 20 CLINICAL RESOURCE HUB, BOISE VA MEDICAL CENTER
Mailing Address - Street 2:500 W FORT ST
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702
Mailing Address - Country:US
Mailing Address - Phone:208-422-1000
Mailing Address - Fax:208-422-1038
Practice Address - Street 1:VISN 20 CLINICAL RESOURCE HUB, BOISE VA MEDICAL CENTER
Practice Address - Street 2:500 W FORT ST
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702
Practice Address - Country:US
Practice Address - Phone:208-422-1000
Practice Address - Fax:208-422-1038
Is Sole Proprietor?:No
Enumeration Date:2017-10-04
Last Update Date:2022-12-02
Deactivation Date:2021-08-09
Deactivation Code:
Reactivation Date:2022-11-10
Provider Licenses
StateLicense IDTaxonomies
OR200440946RN163WC0400X, 163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management