Healthcare Provider Details

I. General information

NPI: 1336745710
Provider Name (Legal Business Name): CHRISTINA MARIE RICE CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2020
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 W LANCASTER AVE
BRYN MAWR PA
19010-3805
US

IV. Provider business mailing address

308 AUBREY RD
WYNNEWOOD PA
19096-1908
US

V. Phone/Fax

Practice location:
  • Phone: 610-658-0999
  • Fax:
Mailing address:
  • Phone: 610-209-7676
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLJ-0010389
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberLJ-0010389
License Number StateDE
# 3
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberSP032302
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLJ-0010389
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: