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Individual

DEANNA STAIRES LANGHOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN,CRNP

Contact information

Practice address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
(205) 939-9100
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-114109
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051118092
BCBS
AL
01
051118093
BCBS
AL
01
051118094
BCBS
AL
01
051118095
BCBS
AL
01
051118096
BCBS
AL
01
051118097
BCBS
AL
05
05777014
MS
05
129449
AL
05
129450
AL
05
129451
AL
05
129452
AL
05
129453
AL
05
129454
AL
01
Z21076
VIVA
AL
Enumeration date
05/27/2011
Last updated
05/16/2019
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