Healthcare Provider Details

I. General information

NPI: 1558253146
Provider Name (Legal Business Name): BREANNA FELPS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1976 MICHIGAN AVE
MOBILE AL
36615-1114
US

IV. Provider business mailing address

PO BOX 40128
MOBILE AL
36640-0128
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5910
  • Fax:
Mailing address:
  • Phone: 251-660-5910
  • Fax: 251-660-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-191956
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: