Healthcare Provider Details

I. General information

NPI: 1023599867
Provider Name (Legal Business Name): JEANNINE MARIE RICE CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

319 S MANNING BLVD STE 201
ALBANY NY
12208-1743
US

IV. Provider business mailing address

11580 FELLOWS HILL DR
PLYMOUTH MI
48170-6381
US

V. Phone/Fax

Practice location:
  • Phone: 518-489-3296
  • Fax:
Mailing address:
  • Phone: 716-247-3758
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number001884
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: