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1841707601
ALYSIA DIANE JACKSON
BIRMINGHAM, AL
NPI
1841707601
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: AL 1-143723)
Enumeration Date
2018-01-02
Last Update Date
2018-01-02
Business Address
ALYSIA DIANE JACKSON CRNP
1020 26TH ST S
BIRMINGHAM, AL 35205-2412
Phone number: 205-332-3155
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Mailing Address
ALYSIA DIANE JACKSON CRNP
116 SPRING ST
CALERA, AL 35040-4971
Phone number: 205-482-7480
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