Healthcare Provider Details

I. General information

NPI: 1578481701
Provider Name (Legal Business Name): BRIANNA MARIE RAY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRIANNA M COLQUITT

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1028 28TH ST S
BIRMINGHAM AL
35205-1214
US

IV. Provider business mailing address

1028 28TH ST S
BIRMINGHAM AL
35205-1214
US

V. Phone/Fax

Practice location:
  • Phone: 770-545-7075
  • Fax:
Mailing address:
  • Phone: 770-545-7075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-199278
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: