Healthcare Provider Details

I. General information

NPI: 1487624458
Provider Name (Legal Business Name): KIMBERLY A RICE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12033 AGENCY RD
PARKER AZ
85344-7718
US

IV. Provider business mailing address

PO BOX 95461
CLEVELAND OH
44101-0033
US

V. Phone/Fax

Practice location:
  • Phone: 928-842-7419
  • Fax:
Mailing address:
  • Phone: 928-669-2137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01073579A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD230257
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number4301074988
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number307776
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: