Healthcare Provider Details

I. General information

NPI: 1386623445
Provider Name (Legal Business Name): TERESA LYNN RICE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 09/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W LAKESHORE DR
HOMEWOOD AL
35209-7253
US

IV. Provider business mailing address

35 W LAKESHORE DR
HOMEWOOD AL
35209-7253
US

V. Phone/Fax

Practice location:
  • Phone: 205-226-5900
  • Fax: 205-226-5937
Mailing address:
  • Phone: 205-226-5900
  • Fax: 205-226-5937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-091250
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: