Basic Information
| Provider Information | |||||||||
| NPI: | 1750894382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JAMES | ||||||||
| FirstName: | AMY | ||||||||
| MiddleName: | SALMON | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3686 GRANDVIEW PKWY STE 720 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352433408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059717500 | ||||||||
| FaxNumber: | 2059717572 | ||||||||
| Practice Location | |||||||||
| Address1: | 3686 GRANDVIEW PKWY STE 720 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352433408 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0529717500 | ||||||||
| FaxNumber: | 2059717572 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2017 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | 2017012996 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | PENDING | 05 | AL | MEDICAID |