Healthcare Provider Details

I. General information

NPI: 1073350518
Provider Name (Legal Business Name): MAKAYLA ANN RICE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2024
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 S 17TH ST STE 310
LINCOLN NE
68502-3700
US

IV. Provider business mailing address

PO BOX 860876
MINNEAPOLIS MN
55486-0876
US

V. Phone/Fax

Practice location:
  • Phone: 402-483-8555
  • Fax:
Mailing address:
  • Phone: 402-483-8590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number3381
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: