Provider Demographics
NPI:1598171274
Name:GREENHALGH, CHRISTY (CRNP, FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:
Last Name:GREENHALGH
Suffix:
Gender:F
Credentials:CRNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 SAINT VINCENTS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1601
Mailing Address - Country:US
Mailing Address - Phone:205-558-3484
Mailing Address - Fax:205-930-2158
Practice Address - Street 1:1944 28TH AVE S
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209
Practice Address - Country:US
Practice Address - Phone:205-582-3510
Practice Address - Fax:205-918-7546
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9311006363LF0000X
AL1-164647363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012777100Medicaid