NPI 1578852133 · live from the CMS NPI Registry
Jessica Lee Gillilan Edmondson, CRNP
Nurse Practitioner, Pediatrics in Birmingham, AL. National Provider Identifier 1578852133, active.
NPI record
| NPI | 1578852133 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1600 7th Ave S Bldg Suite516, Birmingham, AL 35233 |
| Practice phone | 205-638-9781 |
| Mailing address | 1153 Al Highway 205, Boaz, AL 35956 |
| Enumerated | April 5, 2011 |
| Last updated | June 11, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 1-105098 (AL) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.