Individual provider · Type 1 NPI
Jessica Lee Gillilan Edmondson, CRNP
Pediatric Nurse Practitioner · Birmingham, AL
NPI number
1578852133
Active
Practice location
1600 7th Ave S Bldg SUITE516
Birmingham, AL 35233
Fax (205) 975-7051
Mailing address
1153 Al Highway 205
Boaz, AL 35956-5413
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Nurse Practitioner Primary | 363LP0200X | 1-105098 (AL) |
Pediatric Nurse Practitioner: Definition to come...
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About NPI 1578852133
Jessica Lee Gillilan Edmondson, CRNP's National Provider Identifier is 1578852133, issued on Apr 5, 2011. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Birmingham, AL. The record was last updated on Jun 11, 2018.