Healthcare Provider Details

I. General information

NPI: 1013648377
Provider Name (Legal Business Name): TIFFANY ADAMS MCGEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2022
Last Update Date: 06/17/2022
Certification Date: 06/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 19TH ST S
BIRMINGHAM AL
35233-1927
US

IV. Provider business mailing address

9250 FRANKLIN ST
THORSBY AL
35171-7520
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-8101
  • Fax:
Mailing address:
  • Phone: 205-299-2742
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-158348
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: