Healthcare Provider Details

I. General information

NPI: 1104789494
Provider Name (Legal Business Name): FAMILY FIRST PRIMARY CARE ALABAMA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9288 STOUTS RD
KIMBERLY AL
35091-2005
US

IV. Provider business mailing address

9288 STOUTS RD
KIMBERLY AL
35091-2005
US

V. Phone/Fax

Practice location:
  • Phone: 205-795-0010
  • Fax:
Mailing address:
  • Phone: 205-795-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JEWEL KIRK
Title or Position: OWNER/CRNP
Credential: CRNP
Phone: 205-368-5972