Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 1-123129 | AL |
NPI | 1043672538 |
---|---|
Provider Name | Megan Allmendinger |
First Address | Birmingham, AL 35205-5327 |
Second Address | Birmingham, AL 35205-5327 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2016 |
Last Update Date | 21/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NA | (05) | AL |