1295147437 NPI number — MRS. ELLEN HULL BEVIS CRNP

Table of content: MRS. ELLEN HULL BEVIS CRNP (NPI 1295147437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295147437 NPI number — MRS. ELLEN HULL BEVIS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEVIS
Provider First Name:
ELLEN
Provider Middle Name:
HULL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295147437
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 6TH AVE S
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35233-2110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-996-7546
Provider Business Mailing Address Fax Number:
205-934-5766

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 6TH AVE S
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35233-2110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-996-7546
Provider Business Practice Location Address Fax Number:
205-934-5766
Provider Enumeration Date:
05/22/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  F0114353 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)