Taila Fawn Custred, is a
Registered Nurse based in Parrish, Alabama. Taila Fawn Custred is licensed to practice in Alabama (license number 1125678) and her current practice location is
4718 Cedar Lake Rd, Parrish, Alabama. She can be reached at her office (for appointments etc.) via phone at
(205) 388-8254.
NPI number for Taila Fawn Custred is 1447050679 and her current mailing address is 4718 Cedar Lake Rd, Parrish, Alabama. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1447050679.
Provider's Profile
Full Name | Taila Fawn Custred |
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Gender | Female |
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Speciality | Registered Nurse |
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Location | 4718 Cedar Lake Rd, Parrish, Alabama |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1447050679
- Provider Enumeration Date: 03/17/2025
- Last Update Date: 03/17/2025
Medical Identifiers
Medical identifiers for Taila Fawn Custred such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1447050679 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 1125678 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taila Fawn Custred is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Taila Fawn Custred, 4718 Cedar Lake Rd, Parrish, AL 35580-6130 Ph: (205) 388-8254 | Taila Fawn Custred, 4718 Cedar Lake Rd, Parrish, AL 35580-6130 Ph: (205) 388-8254 |
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