Healthcare Provider Details
I. General information
NPI: 1366787343
Provider Name (Legal Business Name): KRISTEN HOWELL MARTIN CRNP-AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/03/2012
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US
IV. Provider business mailing address
1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US
V. Phone/Fax
- Phone: 205-638-9100
- Fax: 205-975-4623
- Phone: 205-638-9175
- Fax: 205-638-6065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0222X |
| Taxonomy | Critical Care Pediatric Nurse Practitioner |
| License Number | 1-109308 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: