Individual
LISA MATTOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
3500 CLAIRMONT AVE S APT G19, BIRMINGHAM, AL 35222-3548
(205) 937-6196
Mailing address
707 RICHARD ARRINGTON JR BLVD S APT 415, BIRMINGHAM, AL 35233-2161
(205) 937-6196
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-087962
AL
Other
Enumeration date
04/02/2021
Last updated
11/17/2022
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