Provider Demographics
NPI:1629727680
Name:VANCE, JASMINE (CNM)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:VANCE
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3911 CREST LNDG
Mailing Address - Street 2:
Mailing Address - City:IRONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35210-2256
Mailing Address - Country:US
Mailing Address - Phone:216-870-8459
Mailing Address - Fax:
Practice Address - Street 1:2216 HAWKSBURY LN
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-1208
Practice Address - Country:US
Practice Address - Phone:162-870-8459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife