Provider Demographics
NPI:1679812374
Name:BYRUM, NEKESHIA DAWN (CRNP)
Entity type:Individual
Prefix:
First Name:NEKESHIA
Middle Name:DAWN
Last Name:BYRUM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 KAIN AVE
Mailing Address - Street 2:
Mailing Address - City:RAINSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35986-5540
Mailing Address - Country:US
Mailing Address - Phone:256-899-7169
Mailing Address - Fax:
Practice Address - Street 1:550 MEDICAL CENTER DR SW
Practice Address - Street 2:
Practice Address - City:FORT PAYNE
Practice Address - State:AL
Practice Address - Zip Code:35968-3418
Practice Address - Country:US
Practice Address - Phone:256-845-8885
Practice Address - Fax:256-845-9546
Is Sole Proprietor?:No
Enumeration Date:2013-01-31
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-114635363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner