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General NPI Number Information
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NPI Number | 1700360211
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Entity Type | Individual
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Provider Name | JENNIFER ELIZABETH RICE AGNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/20/2018
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 209 GRACE CV
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City | MEDINA
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State | TN
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Zip | 38355-8785
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Country | US
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Telephone | 731-783-0400
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Fax |
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Provider Business Mailing Address
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Address Line | 2123 PARK AVE
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City | MILAN
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State | TN
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Zip | 38358-2822
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Country | US
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Telephone | 731-697-5195
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 171401
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License Number State | TN
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