Provider Demographics
NPI:1760124119
Name:RICE, BRIAN (RN CCM)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:RICE
Suffix:
Gender:M
Credentials:RN CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 W CAMERON BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:MT
Mailing Address - Zip Code:59741-8523
Mailing Address - Country:US
Mailing Address - Phone:406-671-9332
Mailing Address - Fax:877-211-6856
Practice Address - Street 1:3420 W CAMERON BRIDGE RD
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:MT
Practice Address - Zip Code:59741-8523
Practice Address - Country:US
Practice Address - Phone:406-671-9332
Practice Address - Fax:877-211-6856
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN27053163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management