Individual
ALICIA KAE MANSKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP-FAMILY
Contact information
Practice address
615 18TH ST S, BIRMINGHAM, AL 35233-1826
(205) 934-3411
Mailing address
4527 JESSUP LN, HOOVER, AL 35226-6602
(205) 420-3848
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
1-131103
AL
363LF0000X
Family Nurse Practitioner
Primary
1-131103
AL
Other
Enumeration date
03/08/2019
Last updated
06/29/2023
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