Healthcare Provider Details

I. General information

NPI: 1629357173
Provider Name (Legal Business Name): KATHERINE E CARROLL CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE E SCHNEIDER

II. Dates (important events)

Enumeration Date: 08/15/2011
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4511 SOUTHLAKE PKWY
HOOVER AL
35244-3238
US

IV. Provider business mailing address

995 9TH AVE SW
BESSEMER AL
35022-4527
US

V. Phone/Fax

Practice location:
  • Phone: 334-559-5589
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number1-109597
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: