Individual
MRS. KELLY COLEMAN STATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-BC
Contact information
Practice address
3980 COLONNADE PKWY, BIRMINGHAM, AL 35243-2382
(205) 599-3525
Mailing address
3980 COLONNADE PKWY, BIRMINGHAM, AL 35243-2382
(205) 599-3525
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-126752
AL
Other
Enumeration date
10/05/2015
Last updated
10/05/2015
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