Provider Demographics
NPI:1609632207
Name:BICE, LANAE (RN)
Entity Type:Individual
Prefix:
First Name:LANAE
Middle Name:
Last Name:BICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:COALVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84017-0128
Mailing Address - Country:US
Mailing Address - Phone:435-336-3228
Mailing Address - Fax:435-608-4474
Practice Address - Street 1:85 N 50 E
Practice Address - Street 2:
Practice Address - City:COALVILLE
Practice Address - State:UT
Practice Address - Zip Code:84017-5525
Practice Address - Country:US
Practice Address - Phone:435-336-3228
Practice Address - Fax:435-608-4474
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8696919-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse