Healthcare Provider Details

I. General information

NPI: 1538135918
Provider Name (Legal Business Name): VALERIE DANETTE SANFORD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3980 COLONNADE PKWY
BIRMINGHAM AL
35243-2382
US

IV. Provider business mailing address

3980 COLONNADE PKWY
BIRMINGHAM AL
35243-2382
US

V. Phone/Fax

Practice location:
  • Phone: 205-510-5000
  • Fax:
Mailing address:
  • Phone: 205-510-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1070155
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: