Provider Demographics
NPI:1790227544
Name:RICE, PRISCILLA ANNE (CNP)
Entity Type:Individual
Prefix:
First Name:PRISCILLA
Middle Name:ANNE
Last Name:RICE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 FULTON RD NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44703-1463
Mailing Address - Country:US
Mailing Address - Phone:330-265-1682
Mailing Address - Fax:
Practice Address - Street 1:1271 FULTON RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-1463
Practice Address - Country:US
Practice Address - Phone:330-265-1682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH020191363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health