MEDICARE: JESSICA FARROW SPICELAND RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	1-160483	AL

General Provider Information

NPI Number	:	1598546228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA FARROW SPICELAND RN

Provider Business Mailing Address
First Line	:	213 N MOSSY CREEK CIR NW
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35757-6334
Country	:	US
Telephone Number	:	901-489-4269
Fax Number	:

Provider Business Practice Location Address
First Line	:	213 N MOSSY CREEK CIR NW
Second Line	:
City	:	MADISON
State	:	AL
Zip	:	35757-6334
Country	:	US
Telephone Number	:	901-489-4269
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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