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General NPI Number Information
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NPI Number | 1568484913
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Entity Type | Individual
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Provider Name | BRANDY THOMASON TANNER CRNP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 1500 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1602
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Country | US
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Telephone | 205-934-7330
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55310
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City | BIRMINGHAM
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State | AL
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Zip | 35255-5310
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Country | US
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Telephone | 205-731-9701
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Fax |
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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 | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 1-094513
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License Number State | AL
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