Healthcare Provider Details

I. General information

NPI: 1225955743
Provider Name (Legal Business Name): RUQUAYYAH YAZEED APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 SADDLEWOOD LN
MONTGOMERY AL
36109-3393
US

IV. Provider business mailing address

519 SADDLEWOOD LN
MONTGOMERY AL
36109-3393
US

V. Phone/Fax

Practice location:
  • Phone: 334-318-7739
  • Fax:
Mailing address:
  • Phone: 334-318-7739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-153160
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: