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General NPI Number Information
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NPI Number | 1699509950
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Entity Type | Organization
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Legal Business Name | HUMBLE HEART HEALTHCARE
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Dates
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Enumeration Date | 08/29/2024
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 1136 STILLMAN AVE
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City | GADSDEN
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State | AL
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Zip | 35903-2550
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Country | US
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Telephone | 256-393-1490
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Fax |
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Provider Business Mailing Address
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Address Line | 1136 STILLMAN AVE
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City | GADSDEN
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State | AL
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Zip | 35903-2550
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Country | US
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Telephone | 256-900-4004
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Fax | 256-900-3103
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Authorized Official
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Title or Position | OWNER
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Name | KIM DOUTHIT
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Credential | CRNP
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Telephone | 256-900-4004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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