Provider Demographics
NPI:1891114054
Name:RICE, MICHELE YATES (NP)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:YATES
Last Name:RICE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4412 COLUMBIA RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-4562
Mailing Address - Country:US
Mailing Address - Phone:706-210-9990
Mailing Address - Fax:706-210-0771
Practice Address - Street 1:4412 COLUMBIA RD
Practice Address - Street 2:SUITE 106
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-4562
Practice Address - Country:US
Practice Address - Phone:706-210-9990
Practice Address - Fax:706-210-0771
Is Sole Proprietor?:No
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN133053163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology