Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 1-109543 | AL |
NPI | 1013160118 |
---|---|
Provider Name | Sheena R. Champion |
First Address | Birmingham, AL 35249-7613 |
Second Address | Birmingham, AL 35249-7613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 08/02/2017 |