Healthcare Provider Details
I. General information
NPI: 1902287295
Provider Name (Legal Business Name): CHRISTY DARLINE MYRICK CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/12/2015
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
711 NANCE FORD RD SW STE M
HARTSELLE AL
35640-3767
US
IV. Provider business mailing address
711 NANCE FORD RD SW STE M
HARTSELLE AL
35640-3767
US
V. Phone/Fax
- Phone: 256-754-5021
- Fax: 256-754-5024
- Phone: 256-754-5021
- Fax: 256-754-5024
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LG0600X |
| Taxonomy | Gerontology Nurse Practitioner |
| License Number | 1-105765 |
| License Number State | AL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LA2200X |
| Taxonomy | Adult Health Nurse Practitioner |
| License Number | 1-105765 |
| License Number State | AL |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LX0106X |
| Taxonomy | Occupational Health Nurse Practitioner |
| License Number | 1-105765 |
| License Number State | AL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LW0102X |
| Taxonomy | Women's Health Nurse Practitioner |
| License Number | 1-105765 |
| License Number State | AL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: