Healthcare Provider Details

I. General information

NPI: 1881142081
Provider Name (Legal Business Name): ERIN MCKEOWN CUZZORT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN ANGELA MCKEOWN CRNP

II. Dates (important events)

Enumeration Date: 09/15/2016
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 BROOKWOOD BLVD
BIRMINGHAM AL
35209-6801
US

IV. Provider business mailing address

611 BARRISTERS CT
BIRMINGHAM AL
35242-5174
US

V. Phone/Fax

Practice location:
  • Phone: 205-558-9086
  • Fax:
Mailing address:
  • Phone: 228-233-8121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-110158
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: