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General NPI Number Information
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NPI Number | 1083239966
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Entity Type | Individual
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Provider Name | JESSICA MCCLANAHAN CRNP
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Gender | Female
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Dates
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Enumeration Date | 06/16/2020
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 3690 GRANDVIEW PKWY
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City | BIRMINGHAM
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State | AL
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Zip | 35243-3326
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Country | US
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Telephone | 205-971-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 23111 DOWNING PARK CIR
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City | MC CALLA
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State | AL
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Zip | 35111-3082
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Country | US
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Telephone |
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Fax |
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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 | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | SP022875
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LN0005X
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Taxonomy Name | Critical Care Neonatal Nurse Practitioner
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License Number | 1-198456
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | SP022875
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License Number State | PA
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