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Individual

MR. DARRELL C HERNDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1201 11TH AVE S, BIRMINGHAM, AL 35205-3423
(205) 930-7296
(205) 930-7256
Mailing address
PO BOX 55905, BIRMINGHAM, AL 35255-5905
(205) 979-5882
(205) 979-1248

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-040120
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051557594
AL
01
515-33846
BC BS OF AL
AL
01
P00729289
RAILROAD MEDICARE
AL
Enumeration date
11/10/2005
Last updated
07/02/2010
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