Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 32967 | AL |
N | 208000000X | Pediatrician | 32967 | AL |
NPI | 1215295605 |
---|---|
Provider Name | Kathleen Hummel Grisanti |
First Address | Birmingham, AL 35294-0001 |
Second Address | Birmingham, AL 35233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2012 |
Last Update Date | 14/02/2019 |