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General NPI Number Information
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NPI Number | 1871173401
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Entity Type | Individual
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Provider Name | STACEY MEZRANO NP
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Gender | Female
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/04/2024
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Provider Practice Location Address
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Address Line | 3680 GRANDVIEW PKWY STE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3411
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Country | US
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Telephone | 205-971-7500
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Fax | 205-971-7572
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Provider Business Mailing Address
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Address Line | 3680 GRANDVIEW PKWY STE 200
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3411
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Country | US
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Telephone | 205-971-7500
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1-110708
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 1-110708
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-110708
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License Number State | AL
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