Healthcare Provider Details

I. General information

NPI: 1497956551
Provider Name (Legal Business Name): DAVID MICHAEL MOBLEY CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

985 9TH AVE SW SUITE 403
BESSEMER AL
35022-4500
US

IV. Provider business mailing address

2700 10TH AVE S SUITE 305
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-481-8470
  • Fax: 205-481-8473
Mailing address:
  • Phone: 205-939-0139
  • Fax: 205-939-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-070070
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: