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General NPI Number Information
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NPI Number | 1043782675
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Entity Type | Organization
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Legal Business Name | OUTSIDE THE BOX HEALTHCARE LLC
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 11/01/2020
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Provider Practice Location Address
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Address Line | 5730 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0234
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Country | US
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Telephone | 256-907-9700
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Fax | 256-907-9724
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Provider Business Mailing Address
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Address Line | 5730 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0234
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Country | US
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Telephone | 256-907-9700
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Fax | 256-907-9724
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MILLIE ELIZABETH MARTIN
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Credential |
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Telephone | 256-907-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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