Healthcare Provider Details

I. General information

NPI: 1104261973
Provider Name (Legal Business Name): JENNIFER NICOLE MCLEOD SAIZAN AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER NICOLE MCLEOD

II. Dates (important events)

Enumeration Date: 05/06/2013
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CHASE CORPORATE DR STE 300
HOOVER AL
35244-1015
US

IV. Provider business mailing address

3 MOBILE INFIRMARY CIR SUITE 410
MOBILE AL
36607-3520
US

V. Phone/Fax

Practice location:
  • Phone: 312-262-2739
  • Fax: 312-564-4059
Mailing address:
  • Phone: 251-433-3344
  • Fax: 251-433-4052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberR893592
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number1-111203
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: