Healthcare Provider Details

I. General information

NPI: 1154728632
Provider Name (Legal Business Name): ANGELA N STAMPS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2014
Last Update Date: 11/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 5TH AVE E
TUSCALOOSA AL
35401-7421
US

IV. Provider business mailing address

750 5TH AVE E
TUSCALOOSA AL
35401-7421
US

V. Phone/Fax

Practice location:
  • Phone: 205-348-6262
  • Fax: 205-348-0630
Mailing address:
  • Phone: 205-348-6262
  • Fax: 205-348-0630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-112813
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: