MEDICARE: MRS. JENNIFER MORRIS

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	363LF0000X	Family Nurse Practitioner	1-081867	AL

General Provider Information

NPI Number	:	1871225540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JENNIFER MORRIS

Provider Business Mailing Address
First Line	:	2001 FIELDSTOWN RD
Second Line	:
City	:	GARDENDALE
State	:	AL
Zip	:	35071-4628
Country	:	US
Telephone Number	:	205-285-2095
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 FIELDSTOWN RD
Second Line	:
City	:	GARDENDALE
State	:	AL
Zip	:	35071-4628
Country	:	US
Telephone Number	:	205-285-2095
Fax Number	:

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

Provider Enumeration Date	:	06/30/2022
Last Update Date	:	06/30/2022

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