Healthcare Provider Details

I. General information

NPI: 1689262057
Provider Name (Legal Business Name): ABBIE FRIDAY SHARPE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2021
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5720 1ST AVE S
BIRMINGHAM AL
35212-2522
US

IV. Provider business mailing address

5720 1ST AVE S
BIRMINGHAM AL
35212-2522
US

V. Phone/Fax

Practice location:
  • Phone: 205-380-9455
  • Fax:
Mailing address:
  • Phone: 205-532-9812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-153431
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1-153431
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: