Provider Demographics
NPI:1992082069
Name:RYCE, EVELYN (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:
Last Name:RYCE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MONROE STREET. SUITE 1386
Mailing Address - Street 2:ADPH BUREAU OF FAMILY HEALTH SERVICES
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-2815
Mailing Address - Country:US
Mailing Address - Phone:334-206-7959
Mailing Address - Fax:334-206-3998
Practice Address - Street 1:23989 AL HIGHWAY 55
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36420-5470
Practice Address - Country:US
Practice Address - Phone:334-427-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-03
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-118834363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner