Individual
NATHAN T. IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
810 SAINT VINCENTS DR, BIRMINGHAM, AL 35205-1601
(205) 939-7143
Mailing address
255 W MICHIGAN AVE, P. O. BOX 1123, JACKSON, MI 49201-2218
(800) 516-5315
(517) 787-7365
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-125332
AL
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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