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General NPI Number Information
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NPI Number | 1801604483
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Entity Type | Individual
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Provider Name | JASMA DORTCH CRNP
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Gender | Female
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Dates
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Enumeration Date | 12/27/2024
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Last Update Date | 02/22/2025
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Provider Practice Location Address
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Address Line | 450 SAINT EMANUEL ST
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City | MOBILE
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State | AL
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Zip | 36603-2240
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Country | US
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Telephone | 251-574-3368
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Fax |
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Provider Business Mailing Address
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Address Line | 46005 SUNRISE DR
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City | BAY MINETTE
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State | AL
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Zip | 36507-7722
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Country | US
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Telephone | 251-654-4712
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-162323
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License Number State | AL
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