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NPI Code Detail

MEDICARE: MISS ALEXANDRA BLUMENTHAL CRNP

MEDICARE:  MISS ALEXANDRA  BLUMENTHAL  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
1363LP0200XPediatric Nurse Practitioner1-127570AL
2363LP0200XPediatric Nurse PractitionerRN1020730DC

General Provider Information

NPI Number : 1023426442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS ALEXANDRA BLUMENTHAL CRNP
Provider Business Mailing Address
First Line : 1601 4TH AVE S # CPP230
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35233-1723
Country : US
Telephone Number : 205-638-9107
Fax Number : 205-638-9821
Provider Business Practice Location Address
First Line : 1601 4TH AVE S # CPP230
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35233-1723
Country : US
Telephone Number : 205-638-9107
Fax Number : 205-638-9821
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2014
Last Update Date : 07/29/2014

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Directions to “ MISS ALEXANDRA BLUMENTHAL CRNP” Practice Location

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