Provider Demographics
NPI:1922020080
Name:RICE, TRACIE KIM (AUD)
Entity Type:Individual
Prefix:DR
First Name:TRACIE
Middle Name:KIM
Last Name:RICE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 LITTLE SAVANNAH RD
Mailing Address - Street 2:STE 132
Mailing Address - City:CULLOWHEE
Mailing Address - State:NC
Mailing Address - Zip Code:28723
Mailing Address - Country:US
Mailing Address - Phone:828-227-3378
Mailing Address - Fax:828-227-7456
Practice Address - Street 1:4121 LITTLE SAVANNAH RD
Practice Address - Street 2:STE 132
Practice Address - City:CULLOWHEE
Practice Address - State:NC
Practice Address - Zip Code:28723
Practice Address - Country:US
Practice Address - Phone:828-227-3378
Practice Address - Fax:828-227-7456
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2014-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1014237600000X
NC5214231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7001515Medicaid
NC7411909Medicaid