Healthcare Provider Details

I. General information

NPI: 1851082150
Provider Name (Legal Business Name): BRANDY BECKHAM CRNP, ACNPC-AG, CCRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 MOBILE INFIRMARY CIR
MOBILE AL
36607-3513
US

IV. Provider business mailing address

1700 SPRING HILL AVE STE 100
MOBILE AL
36604-1416
US

V. Phone/Fax

Practice location:
  • Phone: 251-554-4195
  • Fax:
Mailing address:
  • Phone: 251-435-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number1-151844
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: