Provider Demographics
NPI:1356434351
Name:RICE-MAHER, POLLY J (APRN)
Entity type:Individual
Prefix:MRS
First Name:POLLY
Middle Name:J
Last Name:RICE-MAHER
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:PO BOX 467
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:KS
Mailing Address - Zip Code:67114-0467
Mailing Address - Country:US
Mailing Address - Phone:316-284-6400
Mailing Address - Fax:316-284-6491
Practice Address - Street 1:9333 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2927
Practice Address - Country:US
Practice Address - Phone:316-634-4700
Practice Address - Fax:316-634-4770
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2019-10-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS74310364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS161459OtherBLUE CROSS BLUE SHIELD
KS202997OtherGREAT WEST HEALTH PARTNER
KS202997OtherGREAT WEST HEALTH PARTNER