Healthcare Provider Details

I. General information

NPI: 1568979292
Provider Name (Legal Business Name): SANTANNA MARIE THOMAS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2018
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 1ST ST N STE 350
ALABASTER AL
35007-8619
US

IV. Provider business mailing address

405 BELCHER ST
CENTREVILLE AL
35042-2946
US

V. Phone/Fax

Practice location:
  • Phone: 205-679-6326
  • Fax:
Mailing address:
  • Phone: 205-926-2992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-148355
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: