Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 1-058428 | AL |
NPI | 1124440201 |
---|---|
Provider Name | Barbara Jernigan |
First Address | Northport, AL 35476-3360 |
Second Address | Northport, AL 35476-3360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2014 |
Last Update Date | 09/01/2014 |