Provider Demographics
NPI:1770773798
Name:RICE, VICKI ANN (RN)
Entity type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:ANN
Last Name:RICE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:ANN
Other - Last Name:SMYTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 AVENIDA ACASO STE A
Mailing Address - Street 2:FACTOR SUPPORT NETWORK PHARMACY
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-8749
Mailing Address - Country:US
Mailing Address - Phone:805-443-7349
Mailing Address - Fax:
Practice Address - Street 1:900 AVENIDA ACASO
Practice Address - Street 2:SUITE A
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-8749
Practice Address - Country:US
Practice Address - Phone:805-388-9336
Practice Address - Fax:805-482-6324
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER022807163W00000X
CA743414163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse