Healthcare Provider Details

I. General information

NPI: 1730664418
Provider Name (Legal Business Name): KATE ARMSTRONG CROCKER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATE ARMSTRONG

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 01/22/2024
Certification Date: 12/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 19TH ST S
BIRMINGHAM AL
35249-1932
US

IV. Provider business mailing address

PO BOX 55310
BIRMINGHAM AL
35255-5310
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4011
  • Fax: 205-297-9411
Mailing address:
  • Phone: 205-731-9701
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-152222
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-152222
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: