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General NPI Number Information
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NPI Number | 1154531127
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Entity Type | Individual
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Provider Name | MARY EVE RICE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/29/2022
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Provider Practice Location Address
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Address Line | 490 DUNLOP LN
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City | CLARKSVILLE
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State | TN
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Zip | 37040-5007
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Country | US
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Telephone | 931-245-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 812 BROOKE VALLEY TRCE
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City | CLARKSVILLE
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State | TN
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Zip | 37043-5933
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Country | US
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Telephone | 931-552-6535
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 12411
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License Number State | TN
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