Healthcare Provider Details

I. General information

NPI: 1821478074
Provider Name (Legal Business Name): LAUREL WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2015
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S JARMAN F. LOWDER BUILDING SUITE 618
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

703 VOLKER HL JARMAN F. LOWDER BUILDING SUITE 618
BIRMINGHAM AL
35294-0001
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9918
  • Fax: 205-638-9919
Mailing address:
  • Phone: 205-934-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-067512
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: