# SENIOR HEALTH SOURCE LLC

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

## Provider details

- **NPI number:** 1750677407
- **Authorized official:** MRS. KAREN L JACKSON CRNP (OWNER)
- **Authorized official phone:** (251) 533-6372

## Contact information

- **Practice address:** 27440 COUNTY ROAD 13, DAPHNE, AL 36526-6222
- **Practice address phone:** (251) 533-6372
- **Mailing address:** PO BOX 7872, SPANISH FORT, AL 36577-7872

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 364SG0600X | Gerontology Clinical Nurse Specialist | 1-087343 | AL | Yes |

## Other

- **Enumeration date:** 06/21/2011
- **Last updated:** 12/30/2011