Healthcare Provider Details

I. General information

NPI: 1396516365
Provider Name (Legal Business Name): SARAH BETH PRINCE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2024
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7063 VETERANS PKWY
PELL CITY AL
35125-5114
US

IV. Provider business mailing address

159 OLD MONTGOMERY HWY APT D
VESTAVIA HILLS AL
35216-1226
US

V. Phone/Fax

Practice location:
  • Phone: 205-338-3301
  • Fax:
Mailing address:
  • Phone: 205-603-5259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: