Healthcare Provider Details

I. General information

NPI: 1346824059
Provider Name (Legal Business Name): ALICE COLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2021
Last Update Date: 05/09/2021
Certification Date: 05/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

148 MAGNOLIA CIR
COLUMBIANA AL
35051-9486
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-184503
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: