Provider Demographics
NPI:1447591466
Name:LETT, JENNIFER P (REGISTERED NURSE)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:P
Last Name:LETT
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 WHITMIRE ST
Mailing Address - Street 2:
Mailing Address - City:LEEDS
Mailing Address - State:AL
Mailing Address - Zip Code:35094-1274
Mailing Address - Country:US
Mailing Address - Phone:205-213-5353
Mailing Address - Fax:205-702-4522
Practice Address - Street 1:1721 WHITMIRE ST
Practice Address - Street 2:
Practice Address - City:LEEDS
Practice Address - State:AL
Practice Address - Zip Code:35094-1274
Practice Address - Country:US
Practice Address - Phone:205-213-5353
Practice Address - Fax:205-702-4522
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-101985163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse