Healthcare Provider Details

I. General information

NPI: 1598021818
Provider Name (Legal Business Name): DEBORAH JONES LANEY CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2012
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

8325 HILL LOOP
LEEDS AL
35094-7907
US

V. Phone/Fax

Practice location:
  • Phone: 205-939-9881
  • Fax:
Mailing address:
  • Phone: 205-699-5887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1-025076
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: