Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | R177578 | MD |
NPI | 1023370673 |
---|---|
Provider Name | Mrs. Kimberly Alice Rice |
First Address | Abingdon, MD 21009-3087 |
Second Address | Baltimore, MD 21287-0010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2012 |
Last Update Date | 11/06/2012 |