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General NPI Number Information
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NPI Number | 1528474699
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Entity Type | Individual
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Provider Name | SAMRA MELONEYSA HUBBARD CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 07/09/2014
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Provider Practice Location Address
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Address Line | 1600 7TH AVE S DEARTH TOWER, ROOM 565
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1711
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Country | US
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Telephone | 205-215-5942
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Fax | 205-638-3689
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Provider Business Mailing Address
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Address Line | 1600 7TH AVE S DEARTH TOWER, ROOM 565
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1711
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Country | US
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Telephone | 205-215-5942
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Fax | 205-638-3689
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1-056074
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License Number State | AL
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