Provider Demographics
NPI:1437862703
Name:BRICE, JESSICA N (LPN)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:N
Last Name:BRICE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13439 166TH PL APT 2F
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3801
Mailing Address - Country:US
Mailing Address - Phone:718-807-1339
Mailing Address - Fax:
Practice Address - Street 1:11440 VAN WYCK EXPY
Practice Address - Street 2:
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2229
Practice Address - Country:US
Practice Address - Phone:718-322-3455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-03
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294044164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse