Healthcare Provider Details

I. General information

NPI: 1598048290
Provider Name (Legal Business Name): DEBORAH A PEINHARDT CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2011
Last Update Date: 05/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1912 AL HIGHWAY 157
CULLMAN AL
35058
US

IV. Provider business mailing address

1948 AL HIGHWAY 157 SUITE 330
CULLMAN AL
35058-0642
US

V. Phone/Fax

Practice location:
  • Phone: 256-737-2000
  • Fax:
Mailing address:
  • Phone: 256-737-2682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-025582
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: