Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1-109781 | AL |
NPI | 1033693411 |
---|---|
Provider Name | Jami Archer |
First Address | Vestavia, AL 35243-2560 |
Second Address | Vestavia, AL 35243-2560 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2018 |
Last Update Date | 29/01/2019 |