Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 1-037115 | AL |
N | 363LC1500X | Nurse Practitioner - Community Health | 1-037115 | AL |
Y | 363LX0001X | Nurse Practitioner - Obstetrics & Gynecology | 1-037115 | AL |
NPI | 1326194416 |
---|---|
Provider Name | Ms. Jenny Bone Andrews |
First Address | Mobile, AL 36652-2048 |
Second Address | Mobile, AL 36603-5341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 28/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1-037115 | STATE LICENSE (01) | AL |
156640 | (05) | AL |
511-43411 | BCBS (01) | AL |