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General NPI Number Information
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NPI Number | 1780899161
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Entity Type | Individual
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Provider Name | CHARLES D RUBLEY CRNP
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Gender | Male
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Dates
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Enumeration Date | 05/11/2007
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Last Update Date | 05/05/2023
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Provider Practice Location Address
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Address Line | 1390 WALNUT ST
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City | SULLIGENT
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State | AL
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Zip | 35586-3841
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Country | US
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Telephone | 205-698-7111
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Fax | 205-698-0511
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Provider Business Mailing Address
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Address Line | 885 3RD ST NE
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City | CARBON HILL
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State | AL
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Zip | 35549-4909
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Country | US
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Telephone | 205-924-6133
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-081378
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License Number State | AL
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