Provider Demographics
NPI:1720784481
Name:BYNUM, ALICE MICHELLE (MPH,CBCS, CPAR,CPC,)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:MICHELLE
Last Name:BYNUM
Suffix:
Gender:F
Credentials:MPH,CBCS, CPAR,CPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 360811
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35236-0811
Mailing Address - Country:US
Mailing Address - Phone:708-595-9469
Mailing Address - Fax:
Practice Address - Street 1:1907 MAYFLOWER DR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-3315
Practice Address - Country:US
Practice Address - Phone:708-595-9469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171400000XOther Service ProvidersHealth & Wellness Coach
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1744R1102XOther Service ProvidersSpecialistResearch Study
No251B00000XAgenciesCase Management
No376G00000XNursing Service Related ProvidersNursing Home Administrator