1760026108 NPI number — HILARY WRIGHT BURKETT RN

Table of content: HILARY WRIGHT BURKETT RN (NPI 1760026108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1760026108 NPI number — HILARY WRIGHT BURKETT RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURKETT
Provider First Name:
HILARY
Provider Middle Name:
WRIGHT
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WRIGHT
Provider Other First Name:
HILARY
Provider Other Middle Name:
HERNDON
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1760026108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UAB COMMUNITY PSYCHIATRY
Provider Second Line Business Mailing Address:
908 20TH STREET SOUTH RM 487
Provider Business Mailing Address City Name:
BIRMIN
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35294
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-934-9715
Provider Business Mailing Address Fax Number:
205-975-8950

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UAB COMMUNITY PSYCHIATRY
Provider Second Line Business Practice Location Address:
908 20TH STREET SOUTH RM 487
Provider Business Practice Location Address City Name:
BIRMIN
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35294
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-934-9715
Provider Business Practice Location Address Fax Number:
205-975-8950
Provider Enumeration Date:
10/29/2019

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: 163WP0809X , with the licence number:  1-177854 , 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)