Healthcare Provider Details

I. General information

NPI: 1073391116
Provider Name (Legal Business Name): HANNAH JO DAVIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3686 GRANDVIEW PKWY STE 300
BIRMINGHAM AL
35243-3404
US

IV. Provider business mailing address

2520 RANDOLPH PL
MOUNTAIN BRK AL
35223-1151
US

V. Phone/Fax

Practice location:
  • Phone: 205-536-7676
  • Fax: 205-939-4477
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-189415
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: