Basic Information
Provider Information
NPI: 1093374985
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRICKLAND
FirstName: KATIE
MiddleName: MICHELLE
NamePrefix: MRS.
NameSuffix:  
Credential: NP-C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 BROWN SPRINGS RD
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361177005
CountryCode: US
TelephoneNumber: 3342737000
FaxNumber:  
Practice Location
Address1: 4145 CARMICHAEL RD
Address2:  
City: MONTGOMERY
State: AL
PostalCode: 361062803
CountryCode: US
TelephoneNumber: 3342737000
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/13/2019
LastUpdateDate: 01/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000X1-131649ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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