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General NPI Number Information
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NPI Number | 1588643720
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Entity Type | Individual
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Provider Name | FORREST LEE NEESE CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/16/2006
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Last Update Date | 08/24/2023
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Provider Practice Location Address
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Address Line | 2451 FILLINGIM ST
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City | MOBILE
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State | AL
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Zip | 36617-2238
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Country | US
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Telephone | 251-471-7035
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Fax | 251-471-7042
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Provider Business Mailing Address
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Address Line | 414 AVALON ST
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City | MOBILE
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State | AL
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Zip | 36608-5817
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Country | US
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Telephone | 251-345-3316
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Fax | 251-345-3316
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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 | APRN11026976
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License Number State | FL
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