Basic Information
| Provider Information | |||||||||
| NPI: | 1073111076 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | VINSON | ||||||||
| FirstName: | ABBY | ||||||||
| MiddleName: | CLAIRE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7500 ROPER TUNNEL RD | ||||||||
| Address2: | |||||||||
| City: | TRUSSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351732182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2058763586 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 151 HAMILTON LN | ||||||||
| Address2: | |||||||||
| City: | CALERA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350408700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056684308 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2020 | ||||||||
| LastUpdateDate: | 10/12/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 1-152709 | AL | Y | Nursing Service Providers | Registered Nurse |
No ID Information.