Healthcare Provider Details

I. General information

NPI: 1649207424
Provider Name (Legal Business Name): AIMEE CHISM HOLLAND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 10/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 6TH AVE S
BIRMINGHAM AL
35233-1601
US

IV. Provider business mailing address

PO BOX 55845
BIRMINGHAM AL
35255-5845
US

V. Phone/Fax

Practice location:
  • Phone: 205-279-2860
  • Fax: 205-252-0197
Mailing address:
  • Phone: 205-279-2860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number1096935
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: