Healthcare Provider Details

I. General information

NPI: 1508275298
Provider Name (Legal Business Name): CALLIE HARDWICK WILLIAMS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2014
Last Update Date: 05/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PILOT MEDICAL DR SUITE 300
BIRMINGHAM AL
35235-3411
US

IV. Provider business mailing address

100 PILOT MEDICAL DR SUITE 300
BIRMINGHAM AL
35235-3411
US

V. Phone/Fax

Practice location:
  • Phone: 205-815-4810
  • Fax: 205-815-4777
Mailing address:
  • Phone: 205-815-4810
  • Fax: 205-815-4777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-119583
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2014010233
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: