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General NPI Number Information
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NPI Number | 1104133693
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Entity Type | Organization
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Legal Business Name | STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 09/07/2010
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Provider Practice Location Address
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Address Line | 1175 23RD STREET NORTH ST. CLAIR COUNTY HEALTH DEPARTMENT
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City | PELL CITY
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State | AL
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Zip | 35125
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Country | US
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Telephone | 205-338-3357
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Fax | 205-338-4863
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Provider Business Mailing Address
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Address Line | 1175 23RD STREET NORTH ST. CLAIR COUNTY HEALTH DEPARTMENT
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City | PELL CITY
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State | AL
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Zip | 35125
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Country | US
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Telephone | 205-338-3357
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Fax | 205-338-4863
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Authorized Official
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Title or Position | CRNP/NURSE PRACTITIONER
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Name | MRS. ARLINDA LESHUN WORMELY
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Credential | CRNP
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Telephone | 205-338-3357
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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 | 1-071785
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License Number State | AL
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