Individual
TRACEY L ACHENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
721 MADISON ST SE, HUNTSVILLE, AL 35801-4408
(256) 880-6711
(256) 880-6712
Mailing address
PO BOX 288, HUNTSVILLE, AL 35804-0288
(256) 880-6711
(256) 880-6712
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-105829
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051531739
—
AL
05
—
051556509
—
AL
01
—
51002179
BLUE SHIELD
AL
01
—
51531739
BLUE SHIELD
AL
Enumeration date
05/09/2006
Last updated
12/11/2020
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