Individual
MELISSA PENNINGTON WOLLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35249
(205) 934-4011
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1075293
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051541128
BLUE CROSS
AL
Enumeration date
05/29/2007
Last updated
04/23/2019
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