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Individual

MR. RICKY JEREMY CARWILE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
8375 HIGHWAY 72 W, MADISON, AL 35758-9573
(256) 265-2012
Mailing address
506 WALKER RD SW, HARTSELLE, AL 35640-3960
(256) 773-1511

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-135527
AL
363LA2200X
Adult Health Nurse Practitioner
1-135527
AL
363LG0600X
Gerontology Nurse Practitioner
1-135527
AL

Other

Enumeration date
01/02/2019
Last updated
01/02/2019
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