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NPI Code Detail

MEDICARE: HARRISON BLAKE HANSARD

MEDICARE:   HARRISON BLAKE HANSARD
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
1163W00000XRegistered Nurse1-185336AL

General Provider Information

NPI Number : 1275376568
Entity Type Code : Individual
Provider Name (Legal Business Name) : HARRISON BLAKE HANSARD
Provider Business Mailing Address
First Line : 3545 GRANDVIEW PKWY APT 301
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-2073
Country : US
Telephone Number : 678-507-6443
Fax Number :
Provider Business Practice Location Address
First Line : 3545 GRANDVIEW PKWY APT 301
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-2073
Country : US
Telephone Number : 678-507-6443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2024
Last Update Date : 06/14/2024

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Directions to “ HARRISON BLAKE HANSARD ” Practice Location

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