Provider Demographics
NPI:1356425318
Name:COST, CHARLOTTE MICHELLE (CRNP)
Entity type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:MICHELLE
Last Name:COST
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 1:1912 AL HIGHWAY 157
Mailing Address - Street 2:ER
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0609
Mailing Address - Country:US
Mailing Address - Phone:256-737-2100
Mailing Address - Fax:256-737-2110
Practice Address - Street 1:1912 AL HIGHWAY 157
Practice Address - Street 2:ER
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0609
Practice Address - Country:US
Practice Address - Phone:256-737-2100
Practice Address - Fax:256-737-2110
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1066788363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALS84447Medicare UPIN
AL000093672Medicare ID - Type Unspecified