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1336756600
VIVIAN ELIZABETH JACKSON
BIRMINGHAM, AL
NPI
1336756600
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: AL 1-062778)
Enumeration Date
2020-09-30
Last Update Date
2020-09-30
Business Address
VIVIAN ELIZABETH JACKSON
1216 25TH ST N
BIRMINGHAM, AL 35234-3139
Phone number: 205-252-2994
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Mailing Address
VIVIAN ELIZABETH JACKSON
PO BOX 2722
JASPER, AL 35502-2722
Phone number: 205-215-3761
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