Provider Demographics
NPI:1245871789
Name:HEINZMAN, JENNIFER LEIGH ANN (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LEIGH ANN
Last Name:HEINZMAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MRS
Other - First Name:JENNIFER
Other - Middle Name:ASH
Other - Last Name:RITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:100 PILOT MEDICAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3412
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:205-815-4777
Practice Address - Street 1:100 PILOT MEDICAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3412
Practice Address - Country:US
Practice Address - Phone:205-815-4810
Practice Address - Fax:205-815-4777
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-094296363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care