Individual
ANOLA G ENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
930 20TH ST S, SUITE 101, BIRMINGHAM, AL 35205-2610
(205) 934-5471
(205) 975-2380
Mailing address
1530 3RD AVE S, CH19-307, BIRMINGHAM, AL 35294-0002
(205) 934-5471
(205) 975-2380
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-041425
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-37420
BCBS OF ALABAMA
—
Enumeration date
01/18/2007
Last updated
07/08/2007
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