Individual
BRAGAN D PETREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
(205) 939-9107
(205) 939-9821
Mailing address
1600 7TH AVE S, CPP 230, BIRMINGHAM, AL 35233-1711
(205) 939-9107
(205) 996-2254
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-096846
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-36931
BLUE CROSS
AL
05
—
891013080
—
AL
Enumeration date
03/24/2008
Last updated
07/31/2008
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