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Individual

JENNIFER K JUSTICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2000 PEPPERELL PKWY, OPELIKA, AL 36801-5452
(334) 528-2499
(334) 528-2497
Mailing address
PO BOX 627, AUBURN, AL 36831-0627
(334) 528-2499
(334) 528-2499

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-087156
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-087156
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102382 1801867338
AL
01
344343
WELLCARE CMO - MCCG
GA
01
430080316
RAILROAD MCR - MCCG
GA
01
51591711
BCBS
AL
01
671345126A
PEACHSTATE CMO - MCCG
GA
05
671345126A
GA
05
671345126B
AL
Enumeration date
05/01/2007
Last updated
05/07/2018
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