Healthcare Provider Details

I. General information

NPI: 1154215846
Provider Name (Legal Business Name): ABBY PHILLIPS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 AIRPORT BLVD STE A107
MOBILE AL
36608-6774
US

IV. Provider business mailing address

6701 AIRPORT BLVD STE A107
MOBILE AL
36608-6774
US

V. Phone/Fax

Practice location:
  • Phone: 251-433-4700
  • Fax:
Mailing address:
  • Phone: 251-433-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-174487
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: