Healthcare Provider Details

I. General information

NPI: 1154432946
Provider Name (Legal Business Name): AUDREY RICE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 E HENRIETTA RD
ROCHESTER NY
14620-4629
US

IV. Provider business mailing address

18 PRINCETON LN
FAIRPORT NY
14450-9021
US

V. Phone/Fax

Practice location:
  • Phone: 585-760-6500
  • Fax:
Mailing address:
  • Phone: 585-425-3921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberF300774
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: