Provider Demographics
NPI:1659425387
Name:RICE, DEBRA M (ARNP)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:M
Last Name:RICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 SAN JUAN AVE
Mailing Address - Street 2:
Mailing Address - City:ALAMOSA
Mailing Address - State:CO
Mailing Address - Zip Code:81101
Mailing Address - Country:US
Mailing Address - Phone:719-589-4400
Mailing Address - Fax:719-589-4200
Practice Address - Street 1:518 SAN JUAN AVE
Practice Address - Street 2:
Practice Address - City:ALAMOSA
Practice Address - State:CO
Practice Address - Zip Code:81101-2556
Practice Address - Country:US
Practice Address - Phone:719-589-4400
Practice Address - Fax:719-589-4200
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO188432363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO82037566Medicaid
COCO303640Medicare PIN