Provider Demographics
NPI:1780844589
Name:RICE, SUSAN RENEE (RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:RENEE
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 1:1207 MAPLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-8839
Mailing Address - Country:US
Mailing Address - Phone:606-416-5376
Mailing Address - Fax:606-416-5376
Practice Address - Street 1:1207 MAPLE HILL DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-8839
Practice Address - Country:US
Practice Address - Phone:606-416-5376
Practice Address - Fax:606-416-5376
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-15
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1074553163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management