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General NPI Number Information
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NPI Number | 1013197649
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Entity Type | Individual
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Provider Name | JENNIFER L. KIESSLING M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 4601 WHITESBURG DR SE SUITE 201
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1676
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Country | US
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Telephone | 256-880-1050
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Fax | 256-213-4681
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Provider Business Mailing Address
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Address Line | 4601 WHITESBURG DR SE SUITE 201
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City | HUNTSVILLE
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State | AL
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Zip | 35802-1676
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Country | US
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Telephone | 256-880-1050
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Fax | 256-213-4681
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 27997
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License Number State | AL
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