Provider Demographics
NPI:1790728087
Name:RICE, JONNA LYNN (CRNA)
Entity Type:Individual
Prefix:
First Name:JONNA
Middle Name:LYNN
Last Name:RICE
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 JACKSON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-1560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 JACKSON PIKE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1560
Practice Address - Country:US
Practice Address - Phone:740-446-5000
Practice Address - Fax:740-441-8058
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CRNA.0020728367500000X
WV43039367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2460484Medicaid
WVP00093178OtherRR MEDICARE
WVDA0096OtherRR MEDICARE
WV2460484Medicaid
OH2051167Medicaid
WV0207026000Medicaid
WV0069146000Medicaid
WV0069146000Medicaid
OH2051167Medicaid
WVDA0096OtherRR MEDICARE
WV001706470OtherMSBCBS
WV001721836OtherMSBCBS
WV0069146000Medicaid
OH2051167Medicaid
WV270052997003OtherTRICARE