Healthcare Provider Details

I. General information

NPI: 1265052732
Provider Name (Legal Business Name): MIRIAM DAVIS ESTES MSN, CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MIRIAM ANAIS DAVIS BSN, RN

II. Dates (important events)

Enumeration Date: 04/24/2020
Last Update Date: 05/17/2022
Certification Date: 05/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 MEADOWVIEW DR
HOOVER AL
35242-7700
US

IV. Provider business mailing address

10 MEADOWVIEW DR
HOOVER AL
35242-7700
US

V. Phone/Fax

Practice location:
  • Phone: 205-547-2323
  • Fax:
Mailing address:
  • Phone: 205-547-2323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-147396
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-147396
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: