Healthcare Provider Details

I. General information

NPI: 1902150873
Provider Name (Legal Business Name): STEPHANIE PAIGE DRIELING CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: STEPHANIE PAIGE GOODIN CRNP

II. Dates (important events)

Enumeration Date: 10/31/2012
Last Update Date: 08/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 ADAMS ST SE SUITE 220
HUNTSVILLE AL
35801-3730
US

IV. Provider business mailing address

930 FRANKLIN ST SE
HUNTSVILLE AL
35801-4312
US

V. Phone/Fax

Practice location:
  • Phone: 256-265-1800
  • Fax: 256-265-1801
Mailing address:
  • Phone: 256-801-6015
  • Fax: 256-801-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License Number1-085536
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-085536
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: