Healthcare Provider Details

I. General information

NPI: 1144898586
Provider Name (Legal Business Name): SURYA B UPRETI CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: SUNNY UPRETI

II. Dates (important events)

Enumeration Date: 06/13/2021
Last Update Date: 02/01/2024
Certification Date: 06/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 6TH AVE S
BIRMINGHAM AL
35233-2110
US

IV. Provider business mailing address

6132 KAREN DAVIE DR NW
HUNTSVILLE AL
35806-1954
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-3338
  • Fax: 205-934-2042
Mailing address:
  • Phone: 256-698-4145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-169397
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-167397
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: