Healthcare Provider Details

I. General information

NPI: 1669400115
Provider Name (Legal Business Name): CATHY FLANAGAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 5TH AVE E
TUSCALOOSA AL
35401-7419
US

IV. Provider business mailing address

750 5TH AVE E
TUSCALOOSA AL
35401-7421
US

V. Phone/Fax

Practice location:
  • Phone: 205-348-1770
  • Fax:
Mailing address:
  • Phone: 205-348-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1-033411
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: