Provider Demographics
NPI:1881604551
Name:LENNING, ROBERT M (CRNA)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:LENNING
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVENUE SOUTH
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233
Mailing Address - Country:US
Mailing Address - Phone:205-638-3994
Mailing Address - Fax:205-638-2087
Practice Address - Street 1:1600 7TH AVENUE SOUTH
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233
Practice Address - Country:US
Practice Address - Phone:205-638-3994
Practice Address - Fax:205-638-2087
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2013-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1027822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL430032997OtherRAILROAD MEDICARE
AL000071890Medicaid
AL71890Medicare ID - Type Unspecified
AL000071890Medicaid