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General NPI Number Information
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NPI Number | 1700247145
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Entity Type | Individual
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Provider Name | MICHELLE RENEE BAGLEY CRNP
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Gender | Female
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Dates
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Enumeration Date | 03/13/2016
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1112 GENE REED RD
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City | BIRMINGHAM
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State | AL
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Zip | 35235-2405
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Country | US
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Telephone | 205-836-2942
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Fax | 205-836-2946
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Provider Business Mailing Address
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Address Line | 4200 COLONNADE PKWY
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City | BIRMINGHAM
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State | AL
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Zip | 35243-2342
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Country | US
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Telephone | 205-971-7613
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1-114191
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 1-114191
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-114191
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License Number State | AL
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