1093437261 NPI number — MRS. DEBRA JEANETTE SANDERS KLODA CRNP

Table of content: MRS. DEBRA JEANETTE SANDERS KLODA CRNP (NPI 1093437261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093437261 NPI number — MRS. DEBRA JEANETTE SANDERS KLODA CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLODA
Provider First Name:
DEBRA
Provider Middle Name:
JEANETTE SANDERS
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:
SANDERS
Provider Other First Name:
DEBRA
Provider Other Middle Name:
JEANETTE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093437261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 ST VINCENTS DR # 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-933-9258
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 ST VINCENTS DRIVE # 600, BIRMINGHAM PULMONARY GROVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35205
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-933-9258
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/14/2022

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: 363LA2100X , with the licence number:  1-190638 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 163W00000X , with the licence number: 1-190638 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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