MEDICARE: JACINTA GAVIN WHITT FNP

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	F02260233	AL

General Provider Information

NPI Number	:	1922953157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JACINTA GAVIN WHITT FNP

Provider Business Mailing Address
First Line	:	9714 WILD FLOWER CIR
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35405-9420
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9714 WILD FLOWER CIR
Second Line	:
City	:	TUSCALOOSA
State	:	AL
Zip	:	35405-9420
Country	:	US
Telephone Number	:	205-393-4096
Fax Number	:	205-393-4096

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

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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