Healthcare Provider Details

I. General information

NPI: 1528631322
Provider Name (Legal Business Name): ANNE NORRIS ESLAVA PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 12/20/2024
Certification Date: 12/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GORDON SMITH DR
MOBILE AL
36617-2319
US

IV. Provider business mailing address

375 HILLCREST RD APT A211
MOBILE AL
36608-3854
US

V. Phone/Fax

Practice location:
  • Phone: 251-305-4660
  • Fax:
Mailing address:
  • Phone: 251-581-5570
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.205
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: