Provider Demographics
NPI:1083206213
Name:POLLARD, LUCY ANN
Entity Type:Individual
Prefix:
First Name:LUCY
Middle Name:ANN
Last Name:POLLARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-1613
Mailing Address - Country:US
Mailing Address - Phone:205-585-6054
Mailing Address - Fax:
Practice Address - Street 1:2208 3RD AVE S
Practice Address - Street 2:
Practice Address - City:IRONDALE
Practice Address - State:AL
Practice Address - Zip Code:35210-1613
Practice Address - Country:US
Practice Address - Phone:205-585-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA8911495OtherDRIVER LICENSE