Healthcare Provider Details

I. General information

NPI: 1477399632
Provider Name (Legal Business Name): INDIA ABRAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KANESIA MICHELLE EATON CCMA

II. Dates (important events)

Enumeration Date: 07/06/2024
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 COTTAGE HILL RD
MOBILE AL
36606-2913
US

IV. Provider business mailing address

606 S CRAFT HWY
MOBILE AL
36617-3606
US

V. Phone/Fax

Practice location:
  • Phone: 251-404-7763
  • Fax: 570-938-4726
Mailing address:
  • Phone: 251-404-7763
  • Fax: 570-938-4726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberN5L2C9Z7
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License NumberC6T9Q3Y5
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: