Healthcare Provider Details

I. General information

NPI: 1700552015
Provider Name (Legal Business Name): KATELYN BREANNA HOOD CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 HIGHWAY 31 S STE 117
DECATUR AL
35603-1538
US

IV. Provider business mailing address

2828 HIGHWAY 31 S STE 117
DECATUR AL
35603-1538
US

V. Phone/Fax

Practice location:
  • Phone: 256-351-2116
  • Fax: 256-669-0559
Mailing address:
  • Phone: 256-351-2116
  • Fax: 256-669-0559

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number1-151220
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-151220
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: