Healthcare Provider Details

I. General information

NPI: 1417423609
Provider Name (Legal Business Name): JANET KERSCHNER BEDSOLE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2018
Last Update Date: 10/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 6TH AVE S
BIRMINGHAM AL
35233-1502
US

IV. Provider business mailing address

1400 6TH AVE S
BIRMINGHAM AL
35233-1502
US

V. Phone/Fax

Practice location:
  • Phone: 205-241-5251
  • Fax: 205-241-5235
Mailing address:
  • Phone: 205-241-5251
  • Fax: 205-241-5235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number353
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: