Provider Demographics
NPI:1609257377
Name:POE, CHRISTOPHER KENNETH (CRNP)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:KENNETH
Last Name:POE
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:323 CADES COVE RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY GRANDE
Mailing Address - State:AL
Mailing Address - Zip Code:36701-0444
Mailing Address - Country:US
Mailing Address - Phone:205-948-7328
Mailing Address - Fax:
Practice Address - Street 1:50 MEDICAL PARK DR E
Practice Address - Street 2:EMERGENCY DEPARTMENT
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3401
Practice Address - Country:US
Practice Address - Phone:205-838-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119967363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care