BRENDA FAYE GAVIN APRN FNP-C AG-ACNP-C NPI 1265812424

NPI Information

NPI: 1265812424
Provider Name: BRENDA FAYE GAVIN, APRN FNP-C AG-ACNP-C
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
100 MEMORIAL HOSPITAL DR STE 1A
MOBILE, AL
ZIP 36608
Phone: (251) 343-6848
Get Directions

Brenda Faye Gavin, APRN FNP-C AG-ACNP-C is a gerontology nurse practitioner in Mobile, AL with 9 years of experience. Brenda Faye Gavin, APRN FNP-C AG-ACNP-C NPI is 1265812424. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

100 MEMORIAL HOSPITAL DR STE 1A
MOBILE, AL
ZIP 36608-128
Phone: (251) 343-6848
Fax: (251) 343-5708

The NPI 1265812424 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/3/2015 and was last updated on 10/2/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	R900157	MISSISSIPPI	No
2	363LF0000X	Nurse Practitioner	Family	1-087281	ALABAMA	No
3	363LG0600X	Nurse Practitioner	Gerontology	1-087281	ALABAMA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	512-42739	OTHER	ALABAMA	BCBS
2	512-42742	OTHER	ALABAMA	BCBS
3	250441	MEDICAID	ALABAMA
4	5896052	OTHER	ALABAMA	UHC
5	Z27049	OTHER	ALABAMA	VIVA HEALTH
6	1265812424	OTHER	MISSISSIPPI	MAGNOLIA HEALTH
7	250364	MEDICAID	ALABAMA
8	250414	MEDICAID	ALABAMA
9	250605	MEDICAID	ALABAMA
10	512-42741	OTHER	ALABAMA	BCBS
11	512-42738	OTHER	ALABAMA	BCBS
12	1265812424	OTHER	ALABAMA	HUMANA MILITARY
13	6858582	OTHER	ALABAMA	AETNA
14	08101023	MEDICAID	MISSISSIPPI
15	A03966A	OTHER	ALABAMA	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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