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General NPI Number Information
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NPI Number | 1609253616
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Entity Type | Individual
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Provider Name | JENNIFER SAMSON CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/28/2015
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 100 CONCOURSE PKWY STE 265
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City | HOOVER
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State | AL
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Zip | 35244-2904
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Country | US
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Telephone | 205-453-4195
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Fax | 205-533-7385
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Provider Business Mailing Address
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Address Line | 100 CONCOURSE PKWY STE 265
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City | HOOVER
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State | AL
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Zip | 35244-2904
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Country | US
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Telephone | 205-453-4195
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Fax | 205-533-7385
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1-122746
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License Number State | AL
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