Healthcare Provider Details

I. General information

NPI: 1295133031
Provider Name (Legal Business Name): DONNA LEE NEWELL PMHCNS-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DONNA LEE COSTABILE RN

II. Dates (important events)

Enumeration Date: 12/10/2014
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CENTURY PARK S SUITE 206
BIRMINGHAM AL
35226-3949
US

IV. Provider business mailing address

110 SOUTHLAKE LN
HOOVER AL
35244-3329
US

V. Phone/Fax

Practice location:
  • Phone: 205-978-7800
  • Fax:
Mailing address:
  • Phone: 205-777-8184
  • Fax: 205-978-7802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number1-031253
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: