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Individual

MARY LOU QUATTLEBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
751 PLEASANT ROW NW, HUNTSVILLE, AL 35816-2537
(256) 533-6311
(256) 536-0801
Mailing address
PO BOX 18488, HUNTSVILLE, AL 35804-8488
(256) 533-6311
(256) 536-0801

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
1076934
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51530690
BCBS OF AL
AL
05
891010260
AL
Enumeration date
11/21/2005
Last updated
09/24/2013
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