Individual
MELISSA ISALENE GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 18TH ST S, BIRMINGHAM, AL 35233-1826
(205) 934-7102
Mailing address
615 18TH ST S, BIRMINGHAM, AL 35233-1826
(205) 934-3411
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-156218
AL
363LA2200X
Adult Health Nurse Practitioner
Primary
1-156218
AL
Other
Enumeration date
11/11/2019
Last updated
10/19/2022
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