Healthcare Provider Details

I. General information

NPI: 1851401780
Provider Name (Legal Business Name): STEPHEN A LERMA CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1256 MILITARY ST S
HAMILTON AL
35570-5003
US

IV. Provider business mailing address

1256 MILITARY ST S
HAMILTON AL
35570-5003
US

V. Phone/Fax

Practice location:
  • Phone: 205-921-6200
  • Fax: 205-921-6260
Mailing address:
  • Phone: 205-921-6450
  • Fax: 205-921-6260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number28569
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: