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General NPI Number Information
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NPI Number | 1093349920
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Entity Type | Organization
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Legal Business Name | BACK TO BASICS HEALTHCARE LLC
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Dates
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Enumeration Date | 02/29/2020
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Last Update Date | 06/10/2020
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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 | OWNER
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Name | MS. ROBIN SCOTT
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Credential | CRNP
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Telephone | 256-302-3773
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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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