Provider Demographics
NPI:1376798603
Name:WHEELER, YOLANDA SMITH (PHD, CRNP, CPNP-AC)
Entity Type:Individual
Prefix:DR
First Name:YOLANDA
Middle Name:SMITH
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PHD, CRNP, CPNP-AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235A CIVITAN INTERNATIONAL RESEARCH CTR
Mailing Address - Street 2:1719 6TH AVENUE SOUTH
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-0001
Mailing Address - Country:US
Mailing Address - Phone:205-996-6385
Mailing Address - Fax:205-996-7333
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-212-7244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-082462163WP0200X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
20081634OtherPEDIATRIC NURSING CERTIFICATION BOARD
AL2896OtherRX NUMBER
AL1-082462OtherALABAMA BOARD OF NURSING