Healthcare Provider Details

I. General information

NPI: 1447088414
Provider Name (Legal Business Name): DEJERIAN W SAENZ DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/22/2024
Last Update Date: 07/22/2024
Certification Date: 07/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1139 CAMERON COVE CIR
LEEDS AL
35094-7808
US

IV. Provider business mailing address

1139 CAMERON COVE CIR
LEEDS AL
35094-7808
US

V. Phone/Fax

Practice location:
  • Phone: 205-552-2921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-183129
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: