Provider Demographics
NPI:1629703095
Name:RICE, JAMES R (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:RICE
Suffix:
Gender:M
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:349 NILES CORTLAND RD NE
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1976
Mailing Address - Country:US
Mailing Address - Phone:330-372-0260
Mailing Address - Fax:330-372-0261
Practice Address - Street 1:349 NILES CORTLAND RD NE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1976
Practice Address - Country:US
Practice Address - Phone:330-372-0260
Practice Address - Fax:330-372-0261
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0031864363LA2100X
OHRN314700363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0005619Medicaid