Provider Demographics
NPI:1942965496
Name:RICE, STACIE SHARET (FNP-BC, MSN-ED, RN)
Entity Type:Individual
Prefix:
First Name:STACIE
Middle Name:SHARET
Last Name:RICE
Suffix:
Gender:F
Credentials:FNP-BC, MSN-ED, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6298
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30722-6298
Mailing Address - Country:US
Mailing Address - Phone:423-310-1642
Mailing Address - Fax:
Practice Address - Street 1:1372 PEACHTREE ST NE STE 100
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3203
Practice Address - Country:US
Practice Address - Phone:470-964-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN227934363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner