MEDICARE: MRS. DENISE GOLDSTEIN RNFA, RN, CNOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0800X	Orthopedic Registered Nurse	1072354	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	051516998	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1427020155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DENISE GOLDSTEIN RNFA, RN, CNOR

Provider Business Mailing Address
First Line	:	805 SAINT VINCENTS DR
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1636
Country	:	US
Telephone Number	:	205-939-3699
Fax Number	:	205-939-0989

Provider Business Practice Location Address
First Line	:	805 SAINT VINCENTS DR
Second Line	:	SUITE 100
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1636
Country	:	US
Telephone Number	:	205-939-3699
Fax Number	:	205-939-0989

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2006
Last Update Date	:	04/25/2011

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Directions to “ MRS. DENISE GOLDSTEIN RNFA, RN, CNOR” Practice Location

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