1427176031 NPI number — BRANDY S. RIVERS C.R.N.A.

Table of content: BRANDY S. RIVERS C.R.N.A. (NPI 1427176031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427176031 NPI number — BRANDY S. RIVERS C.R.N.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIVERS
Provider First Name:
BRANDY
Provider Middle Name:
S.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
C.R.N.A.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
STRICKLIN
Provider Other First Name:
BRANDY
Provider Other Middle Name:
S.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
C.R.N.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427176031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 235022
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MONTGOMERY
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36123-5022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
334-386-2051
Provider Business Mailing Address Fax Number:
334-396-6929

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
315 W HICKORY ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SYLACAUGA
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35150-2913
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
334-286-3579
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2007

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: 367500000X , with the licence number:  1-085693 , 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 © 2007-2025 www.npivalidator.com