Provider Demographics
NPI:1710462486
Name:RICE, MARIJA S (CRNP)
Entity Type:Individual
Prefix:
First Name:MARIJA
Middle Name:S
Last Name:RICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:SINKING SPRING
Mailing Address - State:PA
Mailing Address - Zip Code:19608-8621
Mailing Address - Country:US
Mailing Address - Phone:610-670-2522
Mailing Address - Fax:610-670-7736
Practice Address - Street 1:4400 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-8621
Practice Address - Country:US
Practice Address - Phone:610-670-2522
Practice Address - Fax:610-670-7736
Is Sole Proprietor?:No
Enumeration Date:2018-09-28
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN634681163W00000X
PASP019633207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No163W00000XNursing Service ProvidersRegistered Nurse