Individual
VY LE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3693 GRAND CENTRAL AVE, FULTONDALE, AL 35068-1997
(205) 253-1233
Mailing address
3693 GRAND CENTRAL AVE, FULTONDALE, AL 35068-1997
(205) 253-1233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-175910
AL
Other
Enumeration date
12/19/2025
Last updated
12/19/2025
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