Healthcare Provider Details

I. General information

NPI: 1730028416
Provider Name (Legal Business Name): HALLIANNE HOBSON HERNDON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3690 GRANDVIEW PKWY
BIRMINGHAM AL
35243-3326
US

IV. Provider business mailing address

2229 LYNNGATE DR
HOOVER AL
35216-5213
US

V. Phone/Fax

Practice location:
  • Phone: 205-971-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-182261
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: