Provider Demographics
NPI:1093437261
Name:KLODA, DEBRA JEANETTE SANDERS (CRNP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:JEANETTE SANDERS
Last Name:KLODA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:JEANETTE
Other - Last Name:SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:800 ST VINCENTS DR # 600
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205
Mailing Address - Country:US
Mailing Address - Phone:205-933-9258
Mailing Address - Fax:
Practice Address - Street 1:800 ST VINCENTS DRIVE # 600, BIRMINGHAM PULMONARY GROVE
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205
Practice Address - Country:US
Practice Address - Phone:205-933-9258
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-14
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-190638363LA2100X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163W00000XNursing Service ProvidersRegistered Nurse