Quattlebaum, Mary Lou

Quattlebaum, Mary Lou is an sole proprietor health care provider with primary practice located at 751 Pleasant Row Nw , Huntsville AL 35816-2537. She recently has only one registered license in Nursing Service Providers / General Practice, which is considered as her primary health care specialty. Quattlebaum, Mary Lou can be contacted via phone (256) 533-6311.

Contact Information

Primary practice address
751 Pleasant Row Nw Huntsville AL 35816-2537
Phone: (256) 533-6311
Fax: (256) 536-0801
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 1076934 Alabama

Profile Details

NPI number 1639152994
LBN Legal business name Quattlebaum, Mary Lou
Credentials CRNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 21st, 2005
Last updated Sep 24th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639152994 NPPES
Alabama Other 51530690 BCBS OF AL
Alabama MEDICAID 891010260 BCBS OF AL

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