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NPI Code Detail

MEDICARE: CATIE NOEL GROVE CRNP

MEDICARE: CATIE NOEL GROVE CRNP
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
1363L00000XNurse Practitioner1-171062AL
2163WC0200XCritical Care Medicine Registered Nurse1-171062AL

General Provider Information

NPI Number : 1679213011
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATIE NOEL GROVE CRNP
Provider Business Mailing Address
First Line : PO BOX 11407
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35202-1407
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3980 COLONNADE PKWY
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-2382
Country : US
Telephone Number : 205-510-5000
Fax Number : 205-599-6333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2022
Last Update Date : 06/22/2026

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