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Organization

HUNTSVILLE CARDIOVASCULAR CLINIC, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
REBECCA HEDRICK (ADMINISTRATOR)
(256) 880-1050
Entity
Organization

Contact information

Practice address
4601 WHITESBURG DR SE, SUITE 201, HUNTSVILLE, AL 35802-1676
(256) 880-1050
Mailing address
4601 WHITESBURG DR SE, SUITE 201, HUNTSVILLE, AL 35802-1676
(256) 880-1050

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-109897
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-109897
CRNP COLLABORATIVE PRACTICE LICENSE
AL
Enumeration date
10/30/2013
Last updated
09/10/2019
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