MEDICARE: DR. DANIEL EDWARD RICE JR. CRNA

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	RN630523	PA
2	367500000X	Certified Registered Nurse Anesthetist	076979-23	NH

General Provider Information

NPI Number	:	1639454333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL EDWARD RICE JR. CRNA

Provider Business Mailing Address
First Line	:	3324 EVERGREEN RD
Second Line	:
City	:	PULASKI
State	:	PA
Zip	:	16143-3606
Country	:	US
Telephone Number	:	334-318-6537
Fax Number	:

Provider Business Practice Location Address
First Line	:	168 BAY RD
Second Line	:
City	:	FARMINGTON
State	:	NH
Zip	:	03835-3123
Country	:	US
Telephone Number	:	334-318-6537
Fax Number	:

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

Provider Enumeration Date	:	10/13/2011
Last Update Date	:	02/11/2025

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