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General NPI Number Information
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NPI Number | 1669272860
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Entity Type | Organization
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Legal Business Name | GENESIS NEUROPSYCHIATRY, LLC
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 11743 COUNTY LINE RD STE C
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City | MADISON
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State | AL
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Zip | 35758-3301
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Country | US
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Telephone | 256-880-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 185 WHITESPORT DR SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6486
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Country | US
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Telephone | 256-880-3500
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. STEPHANIE L BLUME
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Credential | CRNP, PMHNP-BC
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Telephone | 256-880-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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