Healthcare Provider Details

I. General information

NPI: 1992349690
Provider Name (Legal Business Name): RASHMIN DHANANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 MEADOW LAKE DR STE 101
HOOVER AL
35242-0302
US

IV. Provider business mailing address

3000 MEADOW LAKE DR STE 101
HOOVER AL
35242-0302
US

V. Phone/Fax

Practice location:
  • Phone: 205-855-5575
  • Fax: 205-272-5040
Mailing address:
  • Phone: 205-855-5575
  • Fax: 205-272-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAG10210130
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-142568
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: