Provider Demographics
NPI:1275014490
Name:RICE, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1333 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:MS
Mailing Address - Zip Code:39773-3180
Mailing Address - Country:US
Mailing Address - Phone:662-295-3257
Mailing Address - Fax:662-295-3257
Practice Address - Street 1:1333 E BROAD ST
Practice Address - Street 2:
Practice Address - City:WEST POINT
Practice Address - State:MS
Practice Address - Zip Code:39773-3180
Practice Address - Country:US
Practice Address - Phone:662-295-3257
Practice Address - Fax:662-295-3257
Is Sole Proprietor?:No
Enumeration Date:2018-08-25
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide