Provider Demographics
NPI:1902221880
Name:RICE, NANCY KELLY (LAC)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:KELLY
Last Name:RICE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:NAYA
Other - Middle Name:
Other - Last Name:RICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:1135 MAKAWAO AVE STE 103
Mailing Address - Street 2:PMB 259
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768
Mailing Address - Country:US
Mailing Address - Phone:808-633-1753
Mailing Address - Fax:
Practice Address - Street 1:3681 BALDWIN AVE
Practice Address - Street 2:G-103
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-633-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2014-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-1003171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist