Provider Demographics
NPI:1477290237
Name:GOLDSMITH, AUDREY DENISE
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:DENISE
Last Name:GOLDSMITH
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 1:1329 FORESTDALE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35214-3022
Mailing Address - Country:US
Mailing Address - Phone:205-470-3300
Mailing Address - Fax:205-734-0919
Practice Address - Street 1:1329 FORESTDALE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35214-3022
Practice Address - Country:US
Practice Address - Phone:205-470-3300
Practice Address - Fax:205-734-0919
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-13
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-121003163WH0200X, 364SH0200X
253Z00000X
AL374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome Health
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty