Provider Demographics
NPI:1407675028
Name:RICE, TAMIKA A
Entity type:Individual
Prefix:
First Name:TAMIKA
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44456 W EDDIE WAY
Mailing Address - Street 2:
Mailing Address - City:MARICOPA
Mailing Address - State:AZ
Mailing Address - Zip Code:85138-6416
Mailing Address - Country:US
Mailing Address - Phone:314-753-3035
Mailing Address - Fax:
Practice Address - Street 1:44456 W EDDIE WAY
Practice Address - Street 2:
Practice Address - City:MARICOPA
Practice Address - State:AZ
Practice Address - Zip Code:85138-6416
Practice Address - Country:US
Practice Address - Phone:314-753-3035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant