Provider Demographics
NPI:1265572416
Name:CHATHAM, JANIE RUTH (CRNP)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:RUTH
Last Name:CHATHAM
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 1:215 EMI GIL DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-4325
Mailing Address - Country:US
Mailing Address - Phone:256-831-7369
Mailing Address - Fax:256-835-8729
Practice Address - Street 1:5919 TRUSSVILLE CROSSING PKWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-8635
Practice Address - Country:US
Practice Address - Phone:205-520-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1053572363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily