Individual
ANNIE MALONE SIQUEIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
619 19TH ST S RM JT845, BIRMINGHAM, AL 35249-1900
(205) 979-5882
(205) 979-1248
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
(205) 297-9411
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-144155
AL
367500000X
Certified Registered Nurse Anesthetist
APN16377
TN
367500000X
Certified Registered Nurse Anesthetist
RN185301
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1527227
—
TN
01
—
4316382
BCBS OF TN
TN
Enumeration date
02/01/2012
Last updated
04/13/2017
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