Individual
JESSICA E POITEVINT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
105 E WATTS ST, ENTERPRISE, AL 36330-2511
(334) 393-5437
(334) 393-4185
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-116339
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-116339
LICENSE NUMBER
AL
Enumeration date
11/06/2017
Last updated
06/14/2022
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