Provider Demographics
NPI:1154075125
Name:CURRY, MISTY AUTUMN (RN)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:AUTUMN
Last Name:CURRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:SPRUCE PINE
Mailing Address - State:AL
Mailing Address - Zip Code:35585-3320
Mailing Address - Country:US
Mailing Address - Phone:125-646-0288
Mailing Address - Fax:
Practice Address - Street 1:1841 AL HIGHWAY 20
Practice Address - Street 2:
Practice Address - City:TOWN CREEK
Practice Address - State:AL
Practice Address - Zip Code:35672-2500
Practice Address - Country:US
Practice Address - Phone:256-685-3336
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-114703163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-114703OtherLICENSE NUMBER