Provider Demographics
NPI:1013259506
Name:PLOURD, KATIE YEAGER (CRNP)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:YEAGER
Last Name:PLOURD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:L
Other - Last Name:YEAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1 INDEPENDENCE PLZ
Mailing Address - Street 2:SUITE 410
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2629
Mailing Address - Country:US
Mailing Address - Phone:205-271-8312
Mailing Address - Fax:205-329-7455
Practice Address - Street 1:212 4TH AVE SE
Practice Address - Street 2:SUITE 300
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3673
Practice Address - Country:US
Practice Address - Phone:205-271-8312
Practice Address - Fax:205-329-7455
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2013-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-109854363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner