Healthcare Provider Details

I. General information

NPI: 1265468813
Provider Name (Legal Business Name): REX REAGAN ENGLAND CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 10/19/2024
Certification Date: 10/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 HUGH DANIEL DR SUITE 300
BIRMINGHAM AL
35242-7146
US

IV. Provider business mailing address

7500 HUGH DANIEL DR SUITE 300
BIRMINGHAM AL
35242-7146
US

V. Phone/Fax

Practice location:
  • Phone: 205-313-7252
  • Fax: 205-313-7272
Mailing address:
  • Phone: 205-313-7252
  • Fax: 205-313-7272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3017668
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-042922
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: