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General NPI Number Information
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NPI Number | 1508743477
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Entity Type | Organization
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Legal Business Name | JANERIC MEDICAL PLLC
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 2308 PANSY ST SW
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City | HUNTSVILLE
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State | AL
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Zip | 35801-3803
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Country | US
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Telephone | 256-533-4377
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Fax | 256-539-7874
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Provider Business Mailing Address
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Address Line | 118 WHEAT RIDGE RD NE
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City | HUNTSVILLE
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State | AL
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Zip | 35811-2524
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Country | US
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Telephone | 256-468-9468
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Fax | 256-539-7874
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | JANA JACKSON
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Credential | NP
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Telephone | 256-652-4882
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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