Healthcare Provider Details

I. General information

NPI: 1598546228
Provider Name (Legal Business Name): JESSICA FARROW SPICELAND RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2023
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6336 PICCADILLY SQUARE DR
MOBILE AL
36609-5143
US

IV. Provider business mailing address

213 N MOSSY CREEK CIR NW
MADISON AL
35757-6334
US

V. Phone/Fax

Practice location:
  • Phone: 251-999-5433
  • Fax:
Mailing address:
  • Phone: 901-489-4269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-160483
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: