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General NPI Number Information
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NPI Number | 1295234722
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Entity Type | Organization
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Legal Business Name | VIGILANT LLC
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Dates
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Enumeration Date | 02/11/2018
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 107 OBRANNAN PARK DR
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City | DOTHAN
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State | AL
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Zip | 36303
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Country | US
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Telephone | 334-769-4669
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 660257
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City | BIRMINGHAM
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State | AL
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Zip | 35266-0257
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Country | US
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Telephone | 205-979-5882
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Fax | 205-979-1248
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN GUY HARRELL
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Credential | CRNA
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Telephone | 334-798-1816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | AL
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