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Individual

HILLARY LAINE GANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
110 23RD ST NW, FAYETTE, AL 35555-1001
(205) 932-3891
(205) 932-3996
Mailing address
2171 COUNTY ROAD 68, FAYETTE, AL 35555-3905
(205) 270-0603

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-084725
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
051557383
AL
01
51003763
BCBS
AL
Enumeration date
07/19/2006
Last updated
09/04/2013
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