Healthcare Provider Details

I. General information

NPI: 1619176062
Provider Name (Legal Business Name): ANGELA FAYE BUCHANAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 07/16/2007
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 Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number1-043503
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: