MEDICARE: ADRIANA RICE RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	962594	TX

General Provider Information

NPI Number	:	1114484292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADRIANA RICE RN

Provider Business Mailing Address
First Line	:	2900 SHADOW OAK CT
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-7506
Country	:	US
Telephone Number	:	518-416-5488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 SHADOW OAK CT
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-7506
Country	:	US
Telephone Number	:	518-416-5488
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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