Healthcare Provider Details

I. General information

NPI: 1538688742
Provider Name (Legal Business Name): STACY WILLIAMS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2017
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 BROOKWOOD MEDICAL CTR DR STE 600
BIRMINGHAM AL
35209-6885
US

IV. Provider business mailing address

3500 BLUE LAKE DR STE 495
VESTAVIA AL
35243-1975
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3036
  • Fax: 205-838-5832
Mailing address:
  • Phone: 205-838-3036
  • Fax: 205-838-5832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number1-132538
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10439850-4405
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-132538
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: