1336548247 NPI number — MRS. JANET ELIZABETH SKINNER CRNP

Table of content: MRS. JANET ELIZABETH SKINNER CRNP (NPI 1336548247)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336548247 NPI number — MRS. JANET ELIZABETH SKINNER CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SKINNER
Provider First Name:
JANET
Provider Middle Name:
ELIZABETH
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:
1336548247
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2728 CHEROKEE CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNTAIN BRK
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35216-1006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-821-7171
Provider Business Mailing Address Fax Number:
205-638-7051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 5TH AVENUE SOUTH
Provider Second Line Business Practice Location Address:
NICU-6TH 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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-638-9480
Provider Business Practice Location Address Fax Number:
205-638-7051
Provider Enumeration Date:
08/15/2014

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: 363LN0000X , with the licence number:  1-081363 , 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)





Copyright © 2007-2024 www.npivalidator.com