| NPI | 1306447776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAWTHORNE Credentialing And Billing Manager 205-292-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-11-03 |
| Last Update Date | 2020-11-04 |