Provider Demographics
NPI:1598923070
Name:TRICE, CONNIE K (PNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:K
Last Name:TRICE
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:CHYO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PNP
Mailing Address - Street 1:3435 S ALAMEDA ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1751
Mailing Address - Country:US
Mailing Address - Phone:316-855-7346
Mailing Address - Fax:361-855-7579
Practice Address - Street 1:3435 S ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1751
Practice Address - Country:US
Practice Address - Phone:316-855-7346
Practice Address - Fax:361-855-7579
Is Sole Proprietor?:No
Enumeration Date:2008-05-30
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP0141363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics