Provider Demographics
NPI:1407328123
Name:GOOLSBY, ABBY OZMENT (CRNP)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:OZMENT
Last Name:GOOLSBY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 EDGECREST DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-5909
Mailing Address - Country:US
Mailing Address - Phone:147-827-9151
Mailing Address - Fax:
Practice Address - Street 1:30 RACQUET CLUB PKWY
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-6185
Practice Address - Country:US
Practice Address - Phone:205-620-1090
Practice Address - Fax:205-620-1153
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-148800363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care