Healthcare Provider Details

I. General information

NPI: 1003465279
Provider Name (Legal Business Name): EMILY KARANJA CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2019
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3401
US

IV. Provider business mailing address

1873 LANE DR
LEEDS AL
35094-1290
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3245
  • Fax:
Mailing address:
  • Phone: 205-238-4012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2019033356
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2019033358
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-130154
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: