Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 1-141582 | AL |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1-141582 | AL |
N | 363LG0600X | Nurse Practitioner - Gerontology | 1-141582 | AL |
NPI | 1023577228 |
---|---|
Provider Name | Brittany Churchwell Gifford |
First Address | Florence, AL 35631-1077 |
Second Address | Florence, AL 35630-5320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2019 |
Last Update Date | 18/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-141582 | LICENSE (01) | AL |