Provider Demographics
NPI:1700026747
Name:RICE, DIANN (RN)
Entity Type:Individual
Prefix:MS
First Name:DIANN
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:DIANN
Other - Middle Name:
Other - Last Name:GONIOTAKIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:10001 PURITAN
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238
Mailing Address - Country:US
Mailing Address - Phone:313-961-4000
Mailing Address - Fax:313-494-4060
Practice Address - Street 1:10001 PURITAN
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238
Practice Address - Country:US
Practice Address - Phone:313-961-4000
Practice Address - Fax:313-494-4060
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704145626163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse