Provider Demographics
NPI:1750504098
Name:RICE, TINA R (RN)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:R
Last Name:RICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 DAVID COLLINS DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-2813
Mailing Address - Country:US
Mailing Address - Phone:615-355-6175
Mailing Address - Fax:615-459-7996
Practice Address - Street 1:108 DAVID COLLINS DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-2813
Practice Address - Country:US
Practice Address - Phone:615-355-6175
Practice Address - Fax:615-459-7996
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN98560163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN98560OtherRN