Healthcare Provider Details

I. General information

NPI: 1710462486
Provider Name (Legal Business Name): MARIJA S RICE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 PENN AVE
SINKING SPRING PA
19608-8621
US

IV. Provider business mailing address

4400 PENN AVE
SINKING SPRING PA
19608-8621
US

V. Phone/Fax

Practice location:
  • Phone: 610-670-2522
  • Fax: 610-670-7736
Mailing address:
  • Phone: 610-670-2522
  • Fax: 610-670-7736

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSP019633
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN634681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: