Healthcare Provider Details

I. General information

NPI: 1356331268
Provider Name (Legal Business Name): JOHN DAVID PARNELL CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 UNIVERSITY BLVD
BIRMINGHAM AL
35233-1816
US

IV. Provider business mailing address

PO BOX 660685
BIRMINGHAM AL
35266-0685
US

V. Phone/Fax

Practice location:
  • Phone: 205-325-8387
  • Fax: 205-325-8594
Mailing address:
  • Phone: 205-979-5882
  • Fax: 205-979-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN117376
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-134813
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: