Healthcare Provider Details

I. General information

NPI: 1043021108
Provider Name (Legal Business Name): DONNA MICHELLE RICE RN, NBC-HWC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA MICHELLE LYDIAN RN

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 01/17/2025
Certification Date: 01/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13908 ROLLING SPRINGS PL
LOUISVILLE KY
40245-7471
US

IV. Provider business mailing address

13908 ROLLING SPRINGS PL
LOUISVILLE KY
40245-7471
US

V. Phone/Fax

Practice location:
  • Phone: 502-594-0397
  • Fax:
Mailing address:
  • Phone: 502-594-0397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberA-4046404
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: