Healthcare Provider Details

I. General information

NPI: 1427654581
Provider Name (Legal Business Name): AMY LEE CAUSEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 08/29/2023
Certification Date: 08/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 SUMMITT
JASPER AL
35501-0114
US

IV. Provider business mailing address

1700 6TH AVE S
BIRMINGHAM AL
35233-1802
US

V. Phone/Fax

Practice location:
  • Phone: 205-686-5113
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-178903
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number178903
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: