Provider Demographics
NPI:1770225260
Name:RICE, EMMA L (NP)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:L
Last Name:RICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2209 JOHN R WOODEN DRIVE
Practice Address - Street 2:COMMUNITY SLEEP MEDICINE CLINIC
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151
Practice Address - Country:US
Practice Address - Phone:765-349-6793
Practice Address - Fax:765-349-6435
Is Sole Proprietor?:No
Enumeration Date:2022-04-13
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28232820A163W00000X, 363LF0000X
INF10210950363LF0000X
IN71012431A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300061677Medicaid
IN264430E29OtherMEDICARE