Healthcare Provider Details

I. General information

NPI: 1861956336
Provider Name (Legal Business Name): HANNAH HOLCOMB FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2019
Last Update Date: 01/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 LONGWOOD DR SW
HUNTSVILLE AL
35801-4522
US

IV. Provider business mailing address

PO BOX 2324
BIRMINGHAM AL
35201-2324
US

V. Phone/Fax

Practice location:
  • Phone: 256-533-6488
  • Fax: 256-533-6495
Mailing address:
  • Phone: 256-533-6488
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-147797
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: