Provider Demographics
NPI:1841354198
Name:RAWLINGS, JENNIFER ANN (PA)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ANN
Last Name:RAWLINGS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 CAHABA RIVER RD
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2317
Mailing Address - Country:US
Mailing Address - Phone:205-397-5200
Mailing Address - Fax:
Practice Address - Street 1:5018 CAHABA RIVER RD
Practice Address - Street 2:
Practice Address - City:VESTAVIA
Practice Address - State:AL
Practice Address - Zip Code:35243-2317
Practice Address - Country:US
Practice Address - Phone:205-397-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2020-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA402363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051525154Medicaid
ALQ29555Medicare UPIN
AL051525154Medicaid
AL051525154Medicaid