Provider Demographics
NPI:1881142081
Name:CUZZORT, ERIN MCKEOWN (CRNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MCKEOWN
Last Name:CUZZORT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:ANGELA
Other - Last Name:MCKEOWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:611 BARRISTERS CT
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-5174
Mailing Address - Country:US
Mailing Address - Phone:228-233-8121
Mailing Address - Fax:
Practice Address - Street 1:509 BROOKWOOD BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-6801
Practice Address - Country:US
Practice Address - Phone:205-558-9086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-15
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-110158363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily