Healthcare Provider Details

I. General information

NPI: 1215742846
Provider Name (Legal Business Name): WANNETTA FINCHER PHMNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2400 GORDON SMITH DR
MOBILE AL
36617-2319
US

IV. Provider business mailing address

5750A SOUTHLAND DR
MOBILE AL
36693-3316
US

V. Phone/Fax

Practice location:
  • Phone: 251-305-4660
  • Fax:
Mailing address:
  • Phone: 251-450-5916
  • Fax: 251-662-7297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-183999
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: