Provider Demographics
NPI:1699509950
Name:HUMBLE HEART HEALTHCARE
Entity type:Organization
Organization Name:HUMBLE HEART HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:DOUTHIT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-900-4004
Mailing Address - Street 1:1136 STILLMAN AVE
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-2550
Mailing Address - Country:US
Mailing Address - Phone:256-900-4004
Mailing Address - Fax:256-900-3103
Practice Address - Street 1:1136 STILLMAN AVE
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-2550
Practice Address - Country:US
Practice Address - Phone:256-393-1490
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-29
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty