Provider Demographics
NPI:1346619368
Name:SHEDD, JODIE (CRNP)
Entity Type:Individual
Prefix:
First Name:JODIE
Middle Name:
Last Name:SHEDD
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 PINE ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-0165
Mailing Address - Country:US
Mailing Address - Phone:334-262-7444
Mailing Address - Fax:
Practice Address - Street 1:1801 PINE ST
Practice Address - Street 2:SUITE 302
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-0165
Practice Address - Country:US
Practice Address - Phone:334-262-7444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-125176363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily