Healthcare Provider Details

I. General information

NPI: 1891139531
Provider Name (Legal Business Name): HEATHER DAWN AUSTIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UAB 1700 6TH AVENUE SOUTH
BIRMINGHAM AL
35249-0001
US

IV. Provider business mailing address

UAB 1700 6TH AVENUE SOUTH
BIRMINGHAM AL
35249-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4260
  • Fax: 205-975-1291
Mailing address:
  • Phone: 205-934-4260
  • Fax: 205-975-1291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number1091012
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: