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Organization

AUTUMN STANFORD, PMHNP-BC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AUTUMN LYNN STANFORD PMHNP-BC (OWNER)
(615) 295-1914
Entity
Organization

Contact information

Practice address
1001 BEAUMONT AVENUE, SUITE 102, BIRMINGHAM, AL 35242
(615) 295-1914
Mailing address
1001 BEAUMONT AVENUE, SUITE 102, BIRMINGHAM, AL 35242

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
01/09/2024
Last updated
01/31/2024
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