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1912339615
KRISSY R CUSTIS
BIRMINGHAM, AL
NPI
1912339615
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: AL 1-102363)
Enumeration Date
2013-08-05
Last Update Date
2013-08-05
Business Address
Mrs. KRISSY R CUSTIS CRNP
50 MEDICAL PARK DR E
BIRMINGHAM, AL 35235-3401
Phone number: 205-838-3104
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Mailing Address
Mrs. KRISSY R CUSTIS CRNP
7051 LAKE RUN DRIVE
BIRMINGHAM, AL 35242
Phone number: 205-838-3245
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