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General NPI Number Information
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NPI Number | 1003318619
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Entity Type | Individual
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Provider Name | ANDREA DIAL
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Gender | Female
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Dates
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Enumeration Date | 02/28/2018
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 1201 11TH AVE S STE 410
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City | BIRMINGHAM
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State | AL
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Zip | 35205-3423
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Country | US
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Telephone | 205-939-4939
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Fax |
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Provider Business Mailing Address
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Address Line | 8506 HIGHLANDS TRCE
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City | TRUSSVILLE
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State | AL
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Zip | 35173-3816
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Country | US
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Telephone | 205-910-9526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1-143782
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 1-143782
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1-143782
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License Number State | AL
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