Healthcare Provider Details

I. General information

NPI: 1144713165
Provider Name (Legal Business Name): JOY VIGNEULLE CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2018
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5804 1ST AVE S
BIRMINGHAM AL
35212-2524
US

IV. Provider business mailing address

130 TWIN WAY
WILSONVILLE AL
35186-8087
US

V. Phone/Fax

Practice location:
  • Phone: 205-380-9455
  • Fax:
Mailing address:
  • Phone: 205-702-5220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-144955
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-144955
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-144955
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: