Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | 1-127319 | AL |
NPI | 1083012033 |
---|---|
Provider Name | Anna Floyd |
First Address | Birmingham, AL 35202-2366 |
Second Address | Birmingham, AL 35211-1320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2014 |
Last Update Date | 30/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
512-58060 | BCBS OF AL (01) | AL |