Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 1-139987 | AL |
NPI | 1497397558 |
---|---|
Provider Name | Jennifer Harrison |
First Address | Sterrett, AL 35147-8152 |
Second Address | Anniston, AL 36201-5714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2019 |
Last Update Date | 26/03/2020 |