Healthcare Provider Details

I. General information

NPI: 1144639675
Provider Name (Legal Business Name): STEPHANIE ENSMINGER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 06/30/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-2321
  • Fax: 205-996-2200
Mailing address:
  • Phone: 205-934-2321
  • Fax: 205-996-2200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-122138
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: