| Mrs Angela Pruitt Durham, NP | |
|
1650 Slaughter Rd Ste A, Madison, AL 35758-8610 | |
| (256) 325-3646 | |
| (256) 325-3647 |
| Full Name | Mrs Angela Pruitt Durham |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 27 Years |
| Location | 1650 Slaughter Rd Ste A, Madison, Alabama |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699862474 | NPI | - | NPPES |
| 51046579DUR | Other | AL | BCBS PROVIDER NUMBER |
| DU000046579 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | RN180719NP (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Crestwood Medical Center | Huntsville, AL | Hospital |
| Huntsville Hospital | Huntsville, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Crestwood Physician Services, Llc | 3476735648 | 37 |
| Entity Name | Crestwood Physician Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1154622520 PECOS PAC ID: 3476735648 Enrollment ID: O20110309000303 |
| Entity Name | Zaheer A Khan Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346679834 PECOS PAC ID: 1456662832 Enrollment ID: O20150626000207 |
| Entity Name | St Luke Integrative Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184282840 PECOS PAC ID: 3274963798 Enrollment ID: O20200424001871 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Angela Pruitt Durham, NP 1 Hospital Dr Sw, Huntsville, AL 35801-6455 Ph: (256) 429-4000 | Mrs Angela Pruitt Durham, NP 1650 Slaughter Rd Ste A, Madison, AL 35758-8610 Ph: (256) 325-3646 |
Krista Young, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 600 Sun Temple Dr, Madison, AL 35758 Phone: 256-975-4291 Fax: 256-288-3334 | |
Dr. Kaitlyn Wendolowski, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12205 County Line Rd, Madison, AL 35758 Phone: 256-325-6722 Fax: 256-517-8082 | |
Natalie R Baker, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 12205 County Line Rd, Suite B, Madison, AL 35758 Phone: 256-325-4365 Fax: 256-461-0393 | |
Chastity D Ayers, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 600 Sun Temple Dr, Madison, AL 35758 Phone: 256-288-3333 Fax: 256-288-3334 | |
Mr. Blake Hamilton Gilliam, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1230 Slaughter Rd Ste C, Madison, AL 35758 Phone: 256-325-0955 | |
Mrs. Ruth Morris Church, NURSE PRACTITIONER Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8216 Madison Blvd, Madison, AL 35758 Phone: 256-464-9991 Fax: 256-464-9994 | |
Jacob Ryan Gray, DNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9238 Madison Blvd Ste 750, Madison, AL 35758 Phone: 256-724-8880 Fax: 888-951-7515 |