Healthcare Provider Details

I. General information

NPI: 1508672510
Provider Name (Legal Business Name): EMILY NICOLE RICH CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2024
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 11TH AVE S
BIRMINGHAM AL
35205-3410
US

IV. Provider business mailing address

2550 GENOA WAY APT 206
VESTAVIA AL
35243-7032
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3411
  • Fax:
Mailing address:
  • Phone: 256-441-2975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-182913
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-182913
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: