Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 5005704 | NC |
NPI | 1023364908 |
---|---|
Provider Name | Kristin Lea Rice |
First Address | Statesville, NC 28687-1845 |
Second Address | Mooresville, NC 28117-8579 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2012 |
Last Update Date | 01/09/2020 |