Healthcare Provider Details

I. General information

NPI: 1750459343
Provider Name (Legal Business Name): TIMOTHY A. CRUMP N.P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MEDICAL PARK DR E SUITE 453
BIRMINGHAM AL
35235-3400
US

IV. Provider business mailing address

2700 10TH AVE S SUITE 305
BIRMINGHAM AL
35205-1200
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3895
  • Fax:
Mailing address:
  • Phone: 205-939-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SA2100X
TaxonomyAcute Care Clinical Nurse Specialist
License Number1-072324
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: