Healthcare Provider Details

I. General information

NPI: 1861808230
Provider Name (Legal Business Name): CHRISTOPHER LOVELL CRNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2014
Last Update Date: 11/04/2022
Certification Date: 11/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S UNIVERSITY BLVD UNIT 6000
MOBILE AL
36608-3274
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5555
  • Fax: 251-660-5559
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-124759
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: