Healthcare Provider Details

I. General information

NPI: 1215598511
Provider Name (Legal Business Name): HALLI FLANNAGIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2019
Last Update Date: 02/14/2024
Certification Date: 02/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

434 E PIKE RD
FALKVILLE AL
35622-5109
US

IV. Provider business mailing address

2941 POINT MALLARD PKWY SE STE N
DECATUR AL
35603-5760
US

V. Phone/Fax

Practice location:
  • Phone: 256-784-2200
  • Fax: 256-784-2203
Mailing address:
  • Phone: 256-432-2822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-134211
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: