Basic Information
| Provider Information | |||||||||
| NPI: | 1407328123 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GOOLSBY | ||||||||
| FirstName: | ABBY | ||||||||
| MiddleName: | OZMENT | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 549 EDGECREST DR | ||||||||
| Address2: | |||||||||
| City: | HOMEWOOD | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352095909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 1478279151 | ||||||||
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| Practice Location | |||||||||
| Address1: | 30 RACQUET CLUB PKWY | ||||||||
| Address2: | |||||||||
| City: | PELHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351246185 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2056201090 | ||||||||
| FaxNumber: | 2056201153 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2018 | ||||||||
| LastUpdateDate: | 08/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 1-148800 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.