Provider Demographics
NPI:1598032310
Name:SMITH, SALLY (NP-C)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:HEART TRANSPLANT SERVICES
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-638-3333
Mailing Address - Fax:205-638-6095
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:HEART TRANSPLANT SERVICES
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-638-3333
Practice Address - Fax:205-638-6095
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-116378363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily