Healthcare Provider Details

I. General information

NPI: 1417920539
Provider Name (Legal Business Name): KARLA HUDSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 MEDICAL PARK DR E SUITE 321
BIRMINGHAM AL
35235-3430
US

IV. Provider business mailing address

52 MEDICAL PARK DR E SUITE 321
BIRMINGHAM AL
35235-3430
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3055
  • Fax: 205-838-3517
Mailing address:
  • Phone: 205-838-3055
  • Fax: 205-838-3517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1053512
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: