# SOUTHERN NEONATAL NURSE PRACTITIONERS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144796673
- **Authorized official:** CYNTHIA GALLOWAY NURSE PRACTITIONER (VICE PRESIDENT/CRNP)
- **Authorized official phone:** (205) 531-2755

## Contact information

- **Practice address:** 995 9TH AVE SW, BESSEMER, AL 35022-4527
- **Practice address phone:** (205) 531-2755
- **Practice address fax:** (205) 565-7939
- **Mailing address:** 8524 HAYES RD, BESSEMER, AL 35022-7926
- **Mailing address phone:** (205) 531-2755
- **Mailing address fax:** (205) 565-7939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LN0000X | Neonatal Nurse Practitioner | — | NULL | Yes |
| 363LN0000X | Neonatal Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/23/2018
- **Last updated:** 10/23/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 111EP1111X | — | AL |
| 05 | — | 363L00000X | — | AL |