Healthcare Provider Details

I. General information

NPI: 1821858572
Provider Name (Legal Business Name): ELLEN BESH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2024
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

IV. Provider business mailing address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

V. Phone/Fax

Practice location:
  • Phone: 901-490-8830
  • Fax:
Mailing address:
  • Phone: 901-490-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-189124
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: