MEDICARE: MRS. LISA BURKE RITCHIE 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	363LA2200X	Adult Health Nurse Practitioner	1-142431	AL

General Provider Information

NPI Number	:	1851802508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISA BURKE RITCHIE CRNP

Provider Business Mailing Address
First Line	:	182 6TH AVENUE SOUTH
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35294-0001
Country	:	US
Telephone Number	:	205-975-2914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1826 6TH AVENUE SOUTH
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35294-3328
Country	:	US
Telephone Number	:	205-801-8415
Fax Number	:

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

Provider Enumeration Date	:	10/21/2017
Last Update Date	:	01/23/2019

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