MEDICARE: MRS. MALLORY NABORS 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
1	363LF0000X	Family Nurse Practitioner	2025037950	MO
2	363LF0000X	Family Nurse Practitioner	1-150483	AL

General Provider Information

NPI Number	:	1851875025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MALLORY NABORS CRNP

Provider Business Mailing Address
First Line	:	2229 CAHABA VALLEY DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-2602
Country	:	US
Telephone Number	:	205-991-8996
Fax Number	:	205-991-8997

Provider Business Practice Location Address
First Line	:	2229 CAHABA VALLEY DR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35242-2602
Country	:	US
Telephone Number	:	205-991-8996
Fax Number	:

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

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	06/09/2026

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