Organization Name: | STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH |
NPI Number: | 1104133693 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ARLINDA LESHUN WORMELY (CRNP/NURSE PRACTITIONER) |
Mailing Address: | 1175 23rd Street North St. Clair County Health Department Pell City |
State: | AL US |
Postal Code: | 35125 |
Phone Number: | 2053383357 |
Fax Number: | 2053384863 |
NPI Enumeration Date: | 09/07/2010 |
NPI Last Update Date: | 09/07/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-071785 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |