Healthcare Provider Details

I. General information

NPI: 1285278150
Provider Name (Legal Business Name): BRITTANY SHEA MACHOWICZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S STE P915
BIRMINGHAM AL
35233-1900
US

IV. Provider business mailing address

208 SQUIRE CIR
HOOVER AL
35244-3529
US

V. Phone/Fax

Practice location:
  • Phone: 205-975-0512
  • Fax: 205-975-6404
Mailing address:
  • Phone: 334-707-3475
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-151172
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-151172
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-151172
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: