Healthcare Provider Details

I. General information

NPI: 1619774247
Provider Name (Legal Business Name): VANESSA ANN MARIE SAMPLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA ANN MARIE STONE

II. Dates (important events)

Enumeration Date: 03/01/2025
Last Update Date: 03/01/2025
Certification Date: 03/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-1888
  • Fax:
Mailing address:
  • Phone: 205-975-1888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number1-189452
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: