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General NPI Number Information
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NPI Number | 1104789494
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Entity Type | Organization
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Legal Business Name | FAMILY FIRST PRIMARY CARE ALABAMA LLC
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 9288 STOUTS RD
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City | KIMBERLY
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State | AL
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Zip | 35091-2005
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Country | US
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Telephone | 205-795-0010
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Fax |
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Provider Business Mailing Address
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Address Line | 9288 STOUTS RD
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City | KIMBERLY
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State | AL
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Zip | 35091-2005
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Country | US
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Telephone | 205-795-0010
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Fax |
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Authorized Official
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Title or Position | OWNER/CRNP
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Name | JEWEL KIRK
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Credential | CRNP
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Telephone | 205-368-5972
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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