Healthcare Provider Details

I. General information

NPI: 1578525770
Provider Name (Legal Business Name): CHERYL RUTH HIROS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2006
Last Update Date: 08/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 1ST ST N SUITE 400B
ALABASTER AL
35007-8706
US

IV. Provider business mailing address

1022 1ST ST N SUITE 400B
ALABASTER AL
35007-8706
US

V. Phone/Fax

Practice location:
  • Phone: 205-621-4799
  • Fax: 205-620-1767
Mailing address:
  • Phone: 205-621-4799
  • Fax: 205-620-1767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number11058245
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: