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General NPI Number Information
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NPI Number | 1982050381
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Entity Type | Individual
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Provider Name | LORRA LEECY HYLAND CRNP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2016
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Last Update Date | 05/04/2016
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Provider Practice Location Address
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Address Line | 1424 MONTCLAIR RD
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City | IRONDALE
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State | AL
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Zip | 35210-2208
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Country | US
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Telephone | 205-956-4150
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Fax |
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Provider Business Mailing Address
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Address Line | 508 OAK TRACE CIR
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City | HOOVER
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State | AL
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Zip | 35244-4515
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Country | US
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Telephone | 305-785-3484
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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 | 1-131139
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License Number State | AL
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