Basic Information
| Provider Information | |||||||||
| NPI: | 1053315309 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RICE | ||||||||
| FirstName: | VIOLET | ||||||||
| MiddleName: | FRANCES | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 190 | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991590190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9073763007 | ||||||||
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| Practice Location | |||||||||
| Address1: | 510 E AMENDE DR | ||||||||
| Address2: | |||||||||
| City: | ODESSA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991597003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5099822614 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 12/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP60913506 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | 296 | AK | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP2300X | 296 | AK | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 363LW0102X | 296 | AK | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LF0000X | AP60913506 | WA | Y | 193400000X SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0227226 | 01 | AK | ASEP PROVIDER # DRUG BILL | OTHER | NP02962 | 05 | AK | MEDICAID | AP60913506 | 01 | WA | WASHINGTON DEPT OF HEALTH | OTHER |