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SOUTHERN FAMILY PRACTICELLC NPI 1770734543


NPI Information

NPI: 1770734543
Provider Name: SOUTHERN FAMILY PRACTICE,LLC
Classification: Nurse Practitioner - 363L00000X
Entity Type: Organization
Address:
100 W LAKE PROFESSIONAL PARK STE 1
GENEVA, AL
ZIP 36340
Phone: (334) 684-9400
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SOUTHERN FAMILY PRACTICE,LLC is a nurse practitioner in Geneva, AL. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. SOUTHERN FAMILY PRACTICE,LLC NPI is 1770734543. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

100 W LAKE PROFESSIONAL PARK STE 1
GENEVA, AL
ZIP 36340-200
Phone: (334) 684-9400
Fax: (334) 684-6262

The provider's authorized official is Cecilia Renee Robinson .
The authorized official title is Nurse Practitioner and has the following contact phone number (334) 684-9400.

The enumeration date for this NPI number is 10/9/2008 and was last updated on 3/23/2009.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1363L00000XNurse Practitioner1-074572Yes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1108157MEDICAIDALABAMA
2051593913OTHERALABAMABLUECROSS BLUESHIELD OF AL.
3510G700444OTHERALABAMAMEDICARE OF ALABAMA

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

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