Healthcare Provider Details

I. General information

NPI: 1659084374
Provider Name (Legal Business Name): MICHELLE RENEE HORNSBY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2022
Last Update Date: 12/27/2022
Certification Date: 12/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

6365 POCAHONTAS RD
BESSEMER AL
35022-6361
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3970
  • Fax:
Mailing address:
  • Phone: 205-915-7590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-068366
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: