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General NPI Number Information
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NPI Number | 1982606455
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Entity Type | Individual
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Provider Name | RANDY DARRELL BUMPERS NP-C
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Gender | Male
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3001 27TH ST N
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City | BIRMINGHAM
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State | AL
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Zip | 35207-4549
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Country | US
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Telephone | 205-502-5808
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Fax | 205-502-5820
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Provider Business Mailing Address
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Address Line | 56 LANCASTER CT
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City | CALERA
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State | AL
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Zip | 35040-4702
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Country | US
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Telephone | 205-668-3346
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Fax | 205-668-3346
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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 | 1-054440
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License Number State | AL
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