Healthcare Provider Details

I. General information

NPI: 1891632162
Provider Name (Legal Business Name): ERIN CORRIE WALDREP RN
Entity Type: Individual
Gender:
Sole Proprietor: N

Provider Other Name: ERIN CORRIE MCSWEENEY

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7901 CRESTWOOD BLVD
IRONDALE AL
35210-2611
US

IV. Provider business mailing address

3088 SUMMIT LN
FULTONDALE AL
35068-6016
US

V. Phone/Fax

Practice location:
  • Phone: 205-844-2968
  • Fax:
Mailing address:
  • Phone: 256-591-1302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-104842
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: