Individual
MRS. CAROLINE BLAKE ELLENBURG YOUNGBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
504 BROOKWOOD BLVD, BIRMINGHAM, AL 35209-6802
(205) 871-9661
(205) 870-1621
Mailing address
504 BROOKWOOD BLVD, BIRMINGHAM, AL 35209-6802
(205) 871-9661
(205) 870-1621
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-120527
AL
363LF0000X
Family Nurse Practitioner
15875
TN
Other
Enumeration date
03/09/2012
Last updated
03/23/2015
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