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General NPI Number Information
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NPI Number | 1740733302
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Entity Type | Individual
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Provider Name | COLETTE LYN RUBRIGHT CRNP
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Gender | Female
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Dates
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Enumeration Date | 08/01/2016
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Last Update Date | 08/01/2016
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Provider Practice Location Address
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Address Line | 2006 BROOKWOOD MEDICAL CTR DR SUITE 103
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City | BIRMINGHAM
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State | AL
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Zip | 35209-6899
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Country | US
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Telephone | 205-877-2707
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Fax | 205-877-2917
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Provider Business Mailing Address
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Address Line | 2151 OLD ROCKY RIDGE RD SUITE 106
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City | BIRMINGHAM
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State | AL
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Zip | 35216-7235
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Country | US
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Telephone | 205-877-2707
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Fax | 205-877-2917
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-123812
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License Number State | AL
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