Individual
BRENDA FAYE GAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN FNP-C AG-ACNP-C
Contact information
Practice address
100 MEMORIAL HOSPITAL DR STE 1A, MOBILE, AL 36608-1128
(251) 343-6848
(251) 343-5708
Mailing address
PO BOX 7987, MOBILE, AL 36670-0987
(251) 633-0573
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
R900157
MS
363LF0000X
Family Nurse Practitioner
1-087281
AL
363LG0600X
Gerontology Nurse Practitioner
Primary
1-087281
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08101023
—
MS
01
—
1265812424
HUMANA MILITARY
AL
01
—
1265812424
MAGNOLIA HEALTH
MS
05
—
250364
—
AL
05
—
250414
—
AL
05
—
250441
—
AL
05
—
250605
—
AL
01
—
512-42738
BCBS
AL
01
—
512-42739
BCBS
AL
01
—
512-42741
BCBS
AL
01
—
512-42742
BCBS
AL
01
—
5896052
UHC
AL
01
—
6858582
AETNA
AL
01
—
A03966A
MEDICARE
AL
01
—
Z27049
VIVA HEALTH
AL
Enumeration date
06/03/2015
Last updated
10/02/2020
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