# SOUTHERN BLESSINGS ADULT AND PEDIATRICS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184204414
- **Authorized official:** TIFFANY TOLLIVER CRNP (OWNER/CRNP)
- **Authorized official phone:** (606) 302-1233

## Contact information

- **Practice address:** 1402 PINEVIEW RD, JASPER, AL 35504-8906
- **Practice address phone:** (606) 302-1233
- **Mailing address:** 1402 PINEVIEW RD, JASPER, AL 35504-8906
- **Mailing address phone:** (606) 302-1233

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/12/2021
- **Last updated:** 04/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1-157411 | — | AL |
| 05 | — | 1003473877 | — | AL |