Basic Information
Provider Information
NPI: 1902145675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SAUL
FirstName: RENEE
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 821 ROCKFORD LN
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352093157
CountryCode: US
TelephoneNumber: 2052906812
FaxNumber:  
Practice Location
Address1: 2000 6TH AVE S
Address2:  
City: BIRMINGHAM
State: AL
PostalCode: 352332110
CountryCode: US
TelephoneNumber: 2058018000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/31/2013
LastUpdateDate: 01/31/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2200X1-062175ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health

No ID Information.


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