Healthcare Provider Details

I. General information

NPI: 1912123746
Provider Name (Legal Business Name): MARGARET B. SMITH C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 07/01/2020
Certification Date: 07/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 BESSEMER SUPER HWY
BESSEMER AL
35228
US

IV. Provider business mailing address

1400 6TH AVENUE SOUTH
BRIMINGHAM AL
35233
US

V. Phone/Fax

Practice location:
  • Phone: 205-930-1135
  • Fax: 205-930-1326
Mailing address:
  • Phone: 205-930-1135
  • Fax: 205-930-1326

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-054250
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: