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Individual

MRS. CHERYL A CLABOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2720 UNIVERSITY BLVD, BIRMINGHAM, AL 35233-3408
(205) 989-1080
(205) 989-1087
Mailing address
2151 OLD ROCKY RIDGE RD, SUITE 106, BIRMINGHAM, AL 35216-7235
(205) 989-1080
(205) 989-1087

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1101428
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009912716
AL
01
194586799
TRICARE
AL
01
515-42275
BLUECROSS BLUESHIELD
AL
01
P00424062
MEDICARE RAILROAD
AL
Enumeration date
01/18/2006
Last updated
03/03/2014
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