Healthcare Provider Details

I. General information

NPI: 1265725196
Provider Name (Legal Business Name): JENNIFER MARIE KIMBRELL C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER MARIE MARLER R.N.

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 08/02/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

930 20TH ST S CH20 SUITE 140
BIRMINGHAM AL
35205-2610
US

IV. Provider business mailing address

1720 2ND AVE S CH19 SUITE 307
BIRMINGHAM AL
35294-2041
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-7027
  • Fax: 205-996-7902
Mailing address:
  • Phone: 205-934-7027
  • Fax: 205-996-7902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1-118391
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-118391
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: