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General NPI Number Information
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NPI Number | 1679086326
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Entity Type | Individual
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Provider Name | JENNAFER ADAIR RAY CRNP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2017
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 817 PRINCETON AVE SW STE 199
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City | BIRMINGHAM
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State | AL
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Zip | 35211-1350
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Country | US
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Telephone | 205-780-1920
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Fax | 205-780-2345
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35202-1407
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 1-164415
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License Number State | AL
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