Provider Demographics
NPI:1952169302
Name:WHITE, JENNY BLASINGAME (NP)
Entity type:Individual
Prefix:
First Name:JENNY
Middle Name:BLASINGAME
Last Name:WHITE
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:JENNY
Other - Middle Name:
Other - Last Name:SKIPWORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:1120 S JACKSON HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5773
Mailing Address - Country:US
Mailing Address - Phone:256-383-4447
Mailing Address - Fax:256-381-7999
Practice Address - Street 1:1106 N CAVE ST
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1358
Practice Address - Country:US
Practice Address - Phone:256-386-7774
Practice Address - Fax:256-386-7780
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-085619363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health