Provider Demographics
NPI:1740733302
Name:RUBRIGHT, COLETTE LYN (CRNP)
Entity type:Individual
Prefix:MS
First Name:COLETTE
Middle Name:LYN
Last Name:RUBRIGHT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2151 OLD ROCKY RIDGE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35216-7235
Mailing Address - Country:US
Mailing Address - Phone:205-877-2707
Mailing Address - Fax:205-877-2917
Practice Address - Street 1:2006 BROOKWOOD MEDICAL CTR DR
Practice Address - Street 2:SUITE 103
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6899
Practice Address - Country:US
Practice Address - Phone:205-877-2707
Practice Address - Fax:205-877-2917
Is Sole Proprietor?:No
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-123812363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily