Individual
RAYMOND A MOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
833 PRINCETON AVE SW STE 200A, BIRMINGHAM, AL 35211
(205) 786-2776
(205) 786-6227
Mailing address
1130 22ND ST S STE 1000, BIRMINGHAM, AL 35205-2881
(469) 893-2065
(469) 893-3065
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
203699
ND
363LA2100X
Acute Care Nurse Practitioner
Primary
1-083338
AL
363LA2100X
Acute Care Nurse Practitioner
R865463
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07506279
—
MS
Enumeration date
03/26/2007
Last updated
11/21/2025
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