Healthcare Provider Details

I. General information

NPI: 1376572685
Provider Name (Legal Business Name): KATHY L REDWOOD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 4TH AVE S
BIRMINGHAM AL
35233-1511
US

IV. Provider business mailing address

1400 4TH AVE S
BIRMINGHAM AL
35233-1511
US

V. Phone/Fax

Practice location:
  • Phone: 205-329-7200
  • Fax: 205-329-7250
Mailing address:
  • Phone: 205-329-7200
  • Fax: 205-329-7250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-025926
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: