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General NPI Number Information
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NPI Number | 1144796673
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Entity Type | Organization
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Legal Business Name | SOUTHERN NEONATAL NURSE PRACTITIONERS, LLC
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Dates
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Enumeration Date | 10/23/2018
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 995 9TH AVE SW
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City | BESSEMER
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State | AL
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Zip | 35022-4527
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Country | US
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Telephone | 205-531-2755
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Fax | 205-565-7939
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Provider Business Mailing Address
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Address Line | 8524 HAYES RD
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City | BESSEMER
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State | AL
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Zip | 35022-7926
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Country | US
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Telephone | 205-531-2755
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Fax | 205-565-7939
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Authorized Official
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Title or Position | VICE PRESIDENT/CRNP
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Name | CYNTHIA GALLOWAY
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Credential | NURSE PRACTITIONER
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Telephone | 205-531-2755
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number |
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License Number State |
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