Healthcare Provider Details

I. General information

NPI: 1548983364
Provider Name (Legal Business Name): STEDMAN BRENT POE BSN, MSN, CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 AL HIGHWAY 157
CULLMAN AL
35058-0609
US

IV. Provider business mailing address

PO BOX 2895
CULLMAN AL
35056-2895
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-2000
  • Fax: 256-737-2152
Mailing address:
  • Phone: 256-737-2000
  • Fax: 256-737-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-157515
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: