Healthcare Provider Details

I. General information

NPI: 1578193892
Provider Name (Legal Business Name): HEATHER DAWN BATTLES NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2020
Last Update Date: 01/26/2020
Certification Date: 01/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9785 US HIGHWAY 278 W
ALTOONA AL
35952-7771
US

IV. Provider business mailing address

9785 US HIGHWAY 278 W
ALTOONA AL
35952-7771
US

V. Phone/Fax

Practice location:
  • Phone: 256-393-9754
  • Fax:
Mailing address:
  • Phone: 256-393-9754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-102646
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: