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General NPI Number Information
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NPI Number | 1194580183
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Entity Type | Individual
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Provider Name | OLIVIA SMITH CARRUTH CRNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 2010 BROOKWOOD MEDICAL CTR DR
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6804
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Country | US
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Telephone | 205-547-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 8752 LODGE LN
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City | COTTONDALE
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State | AL
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Zip | 35453-1306
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Country | US
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Telephone | 205-295-8384
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 1-166689
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License Number State | AL
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