Provider Demographics
NPI:1053961474
Name:RICE, AMY LYNNE (PMHNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LYNNE
Last Name:RICE
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2877 HUTCHINGS COLLEGE RD
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:TN
Mailing Address - Zip Code:38583-6720
Mailing Address - Country:US
Mailing Address - Phone:615-336-3211
Mailing Address - Fax:
Practice Address - Street 1:441 E BROAD ST STE E
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3390
Practice Address - Country:US
Practice Address - Phone:931-510-9231
Practice Address - Fax:207-810-5946
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26699363L00000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty