Provider Demographics
NPI:1528682804
Name:ADAMS, ALI ANDERSON (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ALI
Middle Name:ANDERSON
Last Name:ADAMS
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:MS
Other - First Name:ALI
Other - Middle Name:JORDAN
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:417 3RD AVE SW STE 275
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-1921
Mailing Address - Country:US
Mailing Address - Phone:256-297-3621
Mailing Address - Fax:256-297-3180
Practice Address - Street 1:417 3RD AVE SW STE 275
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3511
Practice Address - Country:US
Practice Address - Phone:256-297-3215
Practice Address - Fax:256-297-3180
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-149238363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health