Provider Demographics
NPI:1437700606
Name:GENOVY, JESSICA GARNER (CRNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:GARNER
Last Name:GENOVY
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 1:2205 BRITAIN AVE SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35803-2040
Mailing Address - Country:US
Mailing Address - Phone:256-550-2254
Mailing Address - Fax:
Practice Address - Street 1:46 SHIELDS RD
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35811-7800
Practice Address - Country:US
Practice Address - Phone:256-382-3680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-135982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine