Individual
DR. NICOLISA D MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Mailing address
3485 INDEPENDENCE DR, HOMEWOOD, AL 35209-5603
(205) 930-0920
(205) 445-0115
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
00019447
AL
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
Primary
19447
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009940783
—
AL
01
—
0366100001
MC NSC
AL
01
—
1911001
UNITED HEALTHCARE
AL
01
—
3069868001
CIGNA
AL
01
—
51096368
MEDICARE
AL
01
—
7693171
AETNA
AL
01
—
D815
MEDICARE GROUP PIN
AL
01
—
H17904
HEALTH SPRINGS
AL
Enumeration date
02/08/2006
Last updated
05/12/2025
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