Provider Demographics
NPI:1386958650
Name:RICE, MELISSA ANN (RN, APRN)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:RICE
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:UNDERWOOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNP
Mailing Address - Street 1:1401 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-3313
Mailing Address - Country:US
Mailing Address - Phone:859-655-6100
Mailing Address - Fax:859-655-6148
Practice Address - Street 1:1401 MADISON AVE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:KY
Practice Address - Zip Code:41011-3313
Practice Address - Country:US
Practice Address - Phone:859-655-6100
Practice Address - Fax:859-655-6148
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.11929-NP363LP0200X
KY3007969363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics