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General NPI Number Information
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NPI Number | 1063904977
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Entity Type | Organization
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Legal Business Name | PREMIER NP INC
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 06/06/2018
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Provider Practice Location Address
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Address Line | 616 CHAFFEE ST
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City | TALLADEGA
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State | AL
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Zip | 35160-2809
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Country | US
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Telephone | 256-362-4197
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Fax |
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Provider Business Mailing Address
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Address Line | 24198 US HIGHWAY 231
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City | RAGLAND
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State | AL
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Zip | 35131-5325
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Country | US
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Telephone | 205-473-6261
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Fax | 205-449-1010
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYLINA KAY MASTERS
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Credential |
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Telephone | 205-473-6261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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