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General NPI Number Information
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NPI Number | 1417558446
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Entity Type | Individual
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Provider Name | MEGHAN ASHLEY PERALTA CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 500 22ND ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-3110
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Country | US
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Telephone | 205-504-6098
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Fax |
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Provider Business Mailing Address
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Address Line | 2000 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-2110
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Country | US
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Telephone | 205-801-8415
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Fax | 205-502-9914
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1-173079
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License Number State | AL
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