Individual
KELLY ANNE PHARIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249-1802
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-164610
AL
363LW0102X
Women's Health Nurse Practitioner
1-164610
AL
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
1-164610
AL
Other
Enumeration date
11/22/2019
Last updated
06/29/2023
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