Individual
SUZANNE L HERRIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2000 6TH AVE S, BIRMINGHAM, AL 35233-2110
(205) 801-8000
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 719
AL
363AM0700X
Medical Physician Assistant
004979
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051111212
BLUE CROSS & BLUE SHIELD
AL
01
—
051111213
BLUE CROSS & BLUE SHIELD
AL
01
—
051111214
BLUE CROSS & BLUE SHIELD
AL
01
—
08488856
MEDICAID OF MISSISSIPPI
MS
05
—
08488856
—
MS
05
—
124578
—
AL
05
—
261470131A
—
GA
Enumeration date
02/22/2007
Last updated
04/25/2011
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