Healthcare Provider Details

I. General information

NPI: 1568600617
Provider Name (Legal Business Name): BARLA THOMAS C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18324 ALABAMA HWY 75
HENAGAR AL
35978
US

IV. Provider business mailing address

18324 ALABAMA HWY 75
HENAGAR AL
35978
US

V. Phone/Fax

Practice location:
  • Phone: 256-657-1101
  • Fax:
Mailing address:
  • Phone: 256-657-1101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-083428
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: