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NPI Code Detail

MEDICARE: MRS. CORA DENICE GIPSON-PRUDE CRNP

MEDICARE: MRS. CORA DENICE GIPSON-PRUDE 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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner1-116561AL

General Provider Information

NPI Number : 1992059547
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CORA DENICE GIPSON-PRUDE CRNP
Provider Business Mailing Address
First Line : 300 VESTAVIA PARKWAY
Second Line : SUITE 2300 - #2384
City : BIRMINGHAM
State : AL
Zip : 35216-3788
Country : US
Telephone Number : 205-948-8344
Fax Number : 205-938-7342
Provider Business Practice Location Address
First Line : 300 VESTAVIA PARKWAY
Second Line : SUITE 2300 - #2384
City : BIRMINGHAM
State : AL
Zip : 35216-3788
Country : US
Telephone Number : 205-933-8101
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2012
Last Update Date : 04/07/2026

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Directions to “ MRS. CORA DENICE GIPSON-PRUDE CRNP” Practice Location

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