Providence Healthcare Services INC

NPI #1689934085 in Mobile, Alabama

Provider Information

NPI Number: 1689934085
Entity Type: Organization
Organization Name: Providence Healthcare Services INC
Primary Specialty: Nurse Practitioner
Enumeration Date: May 21, 2012
Last Updated: May 21, 2012

Practice Location

Address: 6701 AIRPORT BLVD
Address 2: SUITE C132
City: Mobile
State: Alabama
ZIP Code: 36608-6705
Phone: (251) 631-3501

Authorized Official

Name: MR. CLARK P. CHRISTIANSON
Title: PRESIDENT
Phone: (251) 633-1660

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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