Healthcare Provider Details

I. General information

NPI: 1932642899
Provider Name (Legal Business Name): CHRISTY REID CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 11/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 S JACKSON HWY SUITE 201
SHEFFIELD AL
35660-5777
US

IV. Provider business mailing address

1120 S JACKSON HWY SUITE 201
SHEFFIELD AL
35660-5777
US

V. Phone/Fax

Practice location:
  • Phone: 256-314-2550
  • Fax: 256-314-2553
Mailing address:
  • Phone: 256-314-2550
  • Fax: 256-314-2553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-127236
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: