Provider Demographics
NPI:1871826115
Name:RICE, KRISTEN RAE (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:RAE
Last Name:RICE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2424 E 21ST ST STE 340
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1722
Mailing Address - Country:US
Mailing Address - Phone:918-728-3100
Mailing Address - Fax:918-728-3376
Practice Address - Street 1:2424 E 21ST ST STE 340
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1722
Practice Address - Country:US
Practice Address - Phone:918-728-3100
Practice Address - Fax:918-728-3376
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-17
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK29598207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology