Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 1-109969 | AL |
NPI | 1043446800 |
---|---|
Provider Name | Holly Flanagan Mays |
First Address | Anniston, AL 36207-6344 |
Second Address | Anniston, AL 36207-6344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2009 |
Last Update Date | 10/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
167148 | (05) | AL |
511-56902 | BCBS OF ALABAMA (01) | AL |