Provider Demographics
NPI:1346204112
Name:JEMISON, DEBRA (CRNP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:JEMISON
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:
Other - Last Name:TOODLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 TUSCALOOSA AVE SW
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211-1948
Mailing Address - Country:US
Mailing Address - Phone:205-715-6121
Mailing Address - Fax:205-715-6183
Practice Address - Street 1:1308 TUSCALOOSA AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1948
Practice Address - Country:US
Practice Address - Phone:205-715-6121
Practice Address - Fax:205-715-6183
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-030867363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner