Provider Demographics
NPI:1962889428
Name:RICE, AMBUR (CNM)
Entity type:Individual
Prefix:
First Name:AMBUR
Middle Name:
Last Name:RICE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5319 S 500 E STE C
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84405-7218
Mailing Address - Country:US
Mailing Address - Phone:801-917-6104
Mailing Address - Fax:
Practice Address - Street 1:5319 S 500 E STE C
Practice Address - Street 2:
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-7218
Practice Address - Country:US
Practice Address - Phone:801-917-6104
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-04
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12147279-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife