Provider Demographics
NPI:1629784178
Name:GRICE, RONALD BLAINE (APRN)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:BLAINE
Last Name:GRICE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 POYDRAS ST STE 1950
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-3341
Mailing Address - Country:US
Mailing Address - Phone:504-322-3837
Mailing Address - Fax:504-322-3847
Practice Address - Street 1:400 POYDRAS ST STE 1950
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3341
Practice Address - Country:US
Practice Address - Phone:504-322-3837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229365363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health