Healthcare Provider Details

I. General information

NPI: 1053315309
Provider Name (Legal Business Name): VIOLET FRANCES RICE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/18/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 E AMENDE DR
ODESSA WA
99159-7003
US

IV. Provider business mailing address

PO BOX 190
ODESSA WA
99159-0190
US

V. Phone/Fax

Practice location:
  • Phone: 509-982-2614
  • Fax:
Mailing address:
  • Phone: 907-376-3007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP60913506
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number296
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number296
License Number StateAK
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number296
License Number StateAK
# 5
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP60913506
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: