Healthcare Provider Details

I. General information

NPI: 1326396359
Provider Name (Legal Business Name): JAMIE BROOKE SEWELL C.P.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2012
Last Update Date: 10/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S # 5604
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

1600 7TH AVE S # 5604
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9918
  • Fax: 205-638-7455
Mailing address:
  • Phone: 205-638-9918
  • Fax: 205-638-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number1-106783
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: