=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477373660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTANY B REYNOLDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/14/2024
-----------------------------------------------------
Last Update Date | 10/14/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 321 1ST ST N
-----------------------------------------------------
City | ALABASTER
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35007-8768
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-624-4325
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 108 HENLEY TRL
-----------------------------------------------------
City | HELENA
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 35080-6837
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 205-718-1869
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1-124055
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------