Provider Demographics
NPI:1588618383
Name:DRINKARD, CAMMIE RENAY (CRNP)
Entity Type:Individual
Prefix:
First Name:CAMMIE
Middle Name:RENAY
Last Name:DRINKARD
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:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-470-5842
Mailing Address - Fax:251-470-5809
Practice Address - Street 1:3301 KNOLLWOOD DR
Practice Address - Street 2:MED PK 4
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-7003
Practice Address - Country:US
Practice Address - Phone:251-660-5108
Practice Address - Fax:251-660-5792
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-052441363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51509803OtherBLUE CROSS
LA1165824Medicaid
MS00125453Medicaid
FL305188900Medicaid
AL891003890Medicaid
AL51509803OtherBLUE CROSS
AL051509803Medicare ID - Type Unspecified
GA500026375Medicare ID - Type UnspecifiedPGBA RAILROAD