Organization
SOUTHERN BLESSINGS ADULT AND PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY TOLLIVER CRNP (OWNER/CRNP)
(606) 302-1233
Entity
Organization
Contact information
Practice address
1402 PINEVIEW RD, JASPER, AL 35504-8906
(606) 302-1233
Mailing address
1402 PINEVIEW RD, JASPER, AL 35504-8906
(606) 302-1233
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1-157411
—
AL
05
—
1003473877
—
AL
Enumeration date
04/12/2021
Last updated
04/12/2021
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