Provider Demographics
NPI:1275267163
Name:ALSPACH, JENNIE REBECCA (CRNP-BC)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:REBECCA
Last Name:ALSPACH
Suffix:
Gender:F
Credentials:CRNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 NUNNALLY PASS
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5075
Mailing Address - Country:US
Mailing Address - Phone:205-837-1059
Mailing Address - Fax:
Practice Address - Street 1:930 20TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-2610
Practice Address - Country:US
Practice Address - Phone:996-015-3205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-081655363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily