Healthcare Provider Details

I. General information

NPI: 1588041198
Provider Name (Legal Business Name): LYNETTE RICE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 SUMMIT ST SW
NORTH CANTON OH
44720-2974
US

IV. Provider business mailing address

835 SUMMIT ST SW
NORTH CANTON OH
44720-2974
US

V. Phone/Fax

Practice location:
  • Phone: 330-499-0585
  • Fax:
Mailing address:
  • Phone: 330-499-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN142565
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: