Provider Demographics
NPI:1730500158
Name:CHISM, NATALIE (CRNP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:CHISM
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 1:2010 PATTON CHAPEL RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5782
Mailing Address - Country:US
Mailing Address - Phone:205-208-9001
Mailing Address - Fax:205-208-0031
Practice Address - Street 1:2010 PATTON CHAPEL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-5782
Practice Address - Country:US
Practice Address - Phone:205-208-9001
Practice Address - Fax:205-208-0031
Is Sole Proprietor?:No
Enumeration Date:2014-01-03
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-126718363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily