Healthcare Provider Details

I. General information

NPI: 1669395414
Provider Name (Legal Business Name): CALEY PONDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 CHRISTINE AVE
ANNISTON AL
36207-5710
US

IV. Provider business mailing address

31 HOBSON CIR
PIEDMONT AL
36272-7628
US

V. Phone/Fax

Practice location:
  • Phone: 256-236-5631
  • Fax: 256-236-5637
Mailing address:
  • Phone: 256-236-5631
  • Fax: 256-236-5637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1-178815
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: