Provider Demographics
NPI:1447423009
Name:SMALLWOOD, STANLEY FARRELL (CRNP-APRN-BC)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:FARRELL
Last Name:SMALLWOOD
Suffix:
Gender:M
Credentials:CRNP-APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20104 SWANNER BLVD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:TANNER
Mailing Address - State:AL
Mailing Address - Zip Code:35671-3651
Mailing Address - Country:US
Mailing Address - Phone:256-686-3334
Mailing Address - Fax:256-686-3339
Practice Address - Street 1:20104 SWANNER BLVD
Practice Address - Street 2:SUITE 4
Practice Address - City:TANNER
Practice Address - State:AL
Practice Address - Zip Code:35671
Practice Address - Country:US
Practice Address - Phone:256-686-3334
Practice Address - Fax:256-686-3339
Is Sole Proprietor?:No
Enumeration Date:2008-04-03
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-088147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily