Provider Demographics
NPI:1760420871
Name:LABRESH, DONNA D (CRNA)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:D
Last Name:LABRESH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:S
Other - Last Name:POE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 660257
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35266-0257
Mailing Address - Country:US
Mailing Address - Phone:205-979-5882
Mailing Address - Fax:205-979-1248
Practice Address - Street 1:809 UNIVERSITY BLVD E
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-2029
Practice Address - Country:US
Practice Address - Phone:205-343-8500
Practice Address - Fax:205-759-6397
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-056192367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALP63837Medicare UPIN
AL051556425Medicare ID - Type Unspecified