Provider Demographics
NPI:1669747622
Name:MAY, TOMMISHEA GWENIQUA (CRNP)
Entity type:Individual
Prefix:
First Name:TOMMISHEA
Middle Name:GWENIQUA
Last Name:MAY
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 1:8596 HIGHLANDS TRCE
Mailing Address - Street 2:
Mailing Address - City:TRUSSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35173-3816
Mailing Address - Country:US
Mailing Address - Phone:205-413-7823
Mailing Address - Fax:
Practice Address - Street 1:130 RIVERCHASE PKWY E
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1811
Practice Address - Country:US
Practice Address - Phone:877-423-1330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-09
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-114876363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner