Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 1-062704 | AL |
NPI | 1194169581 |
---|---|
Provider Name | Mrs. Donna Denise Ledlow |
First Address | Birmingham, AL 35249-7335 |
Second Address | Birmingham, AL 35249-7335 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2013 |
Last Update Date | 29/04/2013 |