Provider Demographics
NPI:1700869609
Name:DOSS, JENNY R (CRNP)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:R
Last Name:DOSS
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 1:2124 CECIL ASHBURN DR SE STE 150
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2576
Mailing Address - Country:US
Mailing Address - Phone:256-539-3000
Mailing Address - Fax:256-510-5384
Practice Address - Street 1:2124 CECIL ASHBURN DR SE STE 150
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2576
Practice Address - Country:US
Practice Address - Phone:256-539-3000
Practice Address - Fax:256-510-5384
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1067338163WG0000X
AL1-067338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL183698Medicaid
AL1164743068Medicaid
AL891010390Medicaid
ALQ54786Medicare UPIN