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NPI 1578133583

NPI 1578133583 : GARRETT BURK FRANKLIN RN : BIRMINGHAM, AL

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General NPI Number Information
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    NPI Number           |    1578133583
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    Entity Type          |    Individual 
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    Provider Name        |    GARRETT BURK FRANKLIN RN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/30/2021
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    Last Update Date     |    05/26/2023
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Provider Practice Location Address
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    Address Line         |    SAMFORD UNIVERSITY DEPT OF NURSE ANESTHESIA 800 LAKE 
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    City                 |    BIRMINGHAM
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    State                |    AL
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    Zip                  |    35229-0001
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    Country              |    US
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    Telephone            |    205-726-2401
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3712 16TH AVE NE 
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    City                 |    TUSCALOOSA
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    State                |    AL
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    Zip                  |    35406-1572
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    Country              |    US
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    Telephone            |    251-591-8533
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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        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    1-155093
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    License Number State |    AL
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Taxonomy #2
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    Taxonomy Code        |    163WC0200X
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    Taxonomy Name        |    Critical Care Medicine Registered Nurse
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    License Number       |    1-155093
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    License Number State |    AL
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