Individual
MS. VICKIE SUE RICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5247 DIDESSE DR, BATON ROUGE, LA 70808-9153
(225) 215-2193
(225) 215-2194
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 215-2193
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.RX.A10259
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
439867822C
BLUE CROSS BLUE SHIELD
LA
01
—
PA 03387
TEXAS LICENSE
TX
01
—
PA.RX.A10259
PA LICENSE FOR LA,
LA
Enumeration date
06/09/2005
Last updated
03/14/2023
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