MEDICARE: MRS. SUSAN NICOLE RICE FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	APRN11044273	FL

General Provider Information

NPI Number	:	1619833019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SUSAN NICOLE RICE FNP-C

Provider Business Mailing Address
First Line	:	608 LYNDSEY LN
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2254
Country	:	US
Telephone Number	:	518-646-3620
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 LYNDSEY LN
Second Line	:
City	:	WINTER HAVEN
State	:	FL
Zip	:	33884-2254
Country	:	US
Telephone Number	:	518-646-3620
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/29/2025
Last Update Date	:	12/29/2025

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