BRENT MORTENSEN (NPI# 1316308307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316308307 |
| Entity Type | Individual |
| Full Name | BRENT MORTENSEN |
| Credential | CRNP |
| Practice Address |
7105b Bailey Creek Cir Se Huntsville AL 35802-2797 |
| Mailing Address |
1011 Kennesaw Dr Se Huntsville AL 35803-2317 |
| Practice Telephone | 2568827469 |
| Practice Fax Number | 2564250046 |
| Mailing Telephone | 2057672944 |
| Enumeration Date | 2016-03-17 |
| Last Update Date | 2016-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SA2100X |
Clinical Nurse Specialist Specialization: Acute Care |
1-118166 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7105B BAILEY CREEK CIR SE |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35802-2797 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699743021 | Joseph H Hastie Jr. | Family Medicine | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2006-03-10 |
| 1225562747 | Kayla Vaden | Nurse Practitioner | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2017-04-12 |
| 1417229980 | Elena Vladimirovna Robertson | Nurse Practitioner | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2012-01-31 |
| 1962612903 | Stephanie Michelle Burrell | Family Medicine | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2007-05-22 |
| 1104958933 | Phoenix Emergency Care, PC | Nurse Practitioner | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2007-03-09 |
| 1821059288 | Marshall Brian Plotka | Emergency Medicine | 7105b Bailey Creek Cir Se, Huntsville, AL 35802-2797 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174187371 | Susan R. Bechert | Social Worker | Huntsville Psychotherapy and Counseling Services, 7540 S. Memorial Parkway, Suite W, Huntsville, AL 35802 | 2019-04-24 |
| 1932601416 | Crystal Gaskins | Nurse Practitioner | 700 Airport Road Suite D, Huntsville, AL 35802 | 2018-03-01 |
| 1073032736 | Emily Rachel Lapidus | Specialist/Technologist | 310 Devon Circle, Huntsville, AL 35802 | 2017-09-13 |
| 1467992727 | Thrive At Jones Farm | Assisted Living Facility | 2238 Cecil Ashburn Dr Se, Huntsville, AL 35802 | 2017-03-06 |
| 1922554641 | Acts Signature Community Services, Inc. | Internal Medicine | One Clubhouse Avenue, Huntsville, AL 35802 | 2016-09-01 |
| 1578018438 | Sarah Thompson | Marriage & Family Therapist | 116 Lily Flagg Rd Sw Ste D, Huntsville, AL 35802 | 2016-08-22 |
| 1124489166 | Nadine Wormsbacher | Massage Therapist | 919 Willowbrook Dr Suite D, Huntsville, AL 35802 | 2016-03-18 |
| 1962761486 | Alfred Lawrence Watson | Internal Medicine | 2112 Clubhouse Ave, Huntsville, AL 35802 | 2012-05-04 |
| 1992073449 | Susan Gosdin Weiler | Pharmacist | 2784 Carl T Jones Drive, Huntsville, AL 35802 | 2011-12-12 |
| 1518257823 | Bonnie Jo Ferguson | Pharmacist | 4096 Whitesburg Drive, Huntsville, AL 35802 | 2011-04-08 |
| Find all providers in zip 35802 | ||||
| Taxonomy Code | 364SA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528512290 | Margaret Helen Holt | Clinical Nurse Specialist | 101 Sivley Rd Sw, Huntsville, AL 35801-4421 | 2016-08-10 |
| 1801285523 | Kimberly Morris | Clinical Nurse Specialist | 201 Sivley Rd Sw Ste 300, Huntsville, AL 35801-5102 | 2015-01-19 |
| 1598154460 | Elizabeth Cooper | Clinical Nurse Specialist | 101 Sivley Rd Sw, Huntsville, AL 35801-4421 | 2015-01-15 |
| 1386087088 | Michael Brandon Phillips | Clinical Nurse Specialist | 101 Sivley Rd Sw, Huntsville, AL 35801-4421 | 2013-04-11 |
| 1629323654 | Chelsea Renee Colombo | Clinical Nurse Specialist | 1 Hospital Dr Sw, Huntsville, AL 35801-6455 | 2012-07-16 |
| 1912265810 | Gwendolyn Michelle Poleon | Clinical Nurse Specialist | 201 Sivley Rd Sw, Suite 500, Huntsville, AL 35801-5134 | 2012-04-27 |
| 1124304589 | Melissa Ann Flowers | Clinical Nurse Specialist | 930 Franklin St Se, Huntsville, AL 35801-4312 | 2011-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992957575 | Paige C Harris | Clinical Nurse Specialist | 1722 Pine St Ste 700, Montgomery, AL 36106-1125 | 2008-10-15 |
| 1417117953 | Debra Ann Davis | Clinical Nurse Specialist | 1518 N Mckenzie St Ste 400, Foley, AL 36535-2276 | 2008-06-09 |
| 1083165146 | Kimberly Ann Devilbiss | Clinical Nurse Specialist | 5955 Airport Blvd, Mobile, AL 36608 | 2016-10-24 |
| 1407233158 | Forrest Harmon Watkins | Clinical Nurse Specialist | 100 Pilot Medical Dr Ste 300, Birmingham, AL 35235-3412 | 2015-05-01 |
| 1265710164 | Jamie Nichole Cockrell | Clinical Nurse Specialist | 422 E Dr Hicks Blvd, Suite A, Florence, AL 35630-5707 | 2011-07-26 |
| 1609028208 | Laura L Rue | Clinical Nurse Specialist | 273 Winton M Blount Loop, Montgomery, AL 36117-3507 | 2008-10-15 |
| 1750459343 | Timothy A. Crump | Clinical Nurse Specialist | 48 Medical Park Dr E, Suite 453, Birmingham, AL 35235-3400 | 2006-12-01 |
| City | HUNTSVILLE |
| Zip Code | 35802 |
Please comment or provide details below to improve the information on BRENT MORTENSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.