Provider Demographics
NPI:1184316234
Name:TICE, RACHEL JONES (CRNP)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JONES
Last Name:TICE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6285 PARK SOUTH DR
Mailing Address - Street 2:
Mailing Address - City:BESSEMER
Mailing Address - State:AL
Mailing Address - Zip Code:35022-5670
Mailing Address - Country:US
Mailing Address - Phone:205-529-5648
Mailing Address - Fax:
Practice Address - Street 1:6285 PARK SOUTH DR
Practice Address - Street 2:
Practice Address - City:BESSEMER
Practice Address - State:AL
Practice Address - Zip Code:35022-5670
Practice Address - Country:US
Practice Address - Phone:205-529-5648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-180234363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care