MEDICARE: MRS. ELIZABETH DICKMAN RIMMER CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0200X	Pediatric Nurse Practitioner	1-115034	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP93440197	OTHER	FL	ARNP
2	1710243274	OTHER	FL	NPI

General Provider Information

NPI Number	:	1710243274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELIZABETH DICKMAN RIMMER CRNP

Provider Business Mailing Address
First Line	:	2305 HAND AVE
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4191
Country	:	US
Telephone Number	:	251-239-8198
Fax Number	:	251-239-8183

Provider Business Practice Location Address
First Line	:	2305 HAND AVE
Second Line	:
City	:	BAY MINETTE
State	:	AL
Zip	:	36507-4191
Country	:	US
Telephone Number	:	251-239-8198
Fax Number	:	251-239-8183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2012
Last Update Date	:	05/15/2024

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