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General NPI Number Information
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NPI Number | 1316668403
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Entity Type | Organization
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Legal Business Name | QUEEN CITY WOMEN'S HEALTH
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Dates
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Enumeration Date | 09/07/2022
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Last Update Date | 09/07/2022
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Provider Practice Location Address
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Address Line | 108 BROAD ST
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City | SELMA
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State | AL
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Zip | 36701-4639
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Country | US
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Telephone | 334-505-0873
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Fax |
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Provider Business Mailing Address
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Address Line | 207 CRESTWOOD DR
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City | SELMA
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State | AL
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Zip | 36701-6044
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Country | US
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Telephone | 334-505-0873
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER/OWNER
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Name | MS. COURTNEY CAMILLE CARTER
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Credential | CRNP
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Telephone | 334-505-0873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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