Provider Demographics
NPI:1013467935
Name:LOMNECK, CHARITY (CRNP)
Entity Type:Individual
Prefix:
First Name:CHARITY
Middle Name:
Last Name:LOMNECK
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 1:20 MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-3425
Mailing Address - Country:US
Mailing Address - Phone:205-544-2243
Mailing Address - Fax:205-301-2414
Practice Address - Street 1:20 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-3425
Practice Address - Country:US
Practice Address - Phone:205-544-2243
Practice Address - Fax:205-301-2414
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11001665363LF0000X
ALF0916594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily