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Individual

JANSEN WUISAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
5720 1ST AVE S, BIRMINGHAM, AL 35212-2522
(205) 380-9455
Mailing address
5720 1ST AVE S, BIRMINGHAM, AL 35212-2522
(205) 380-9455

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-153604
AL

Other

Enumeration date
10/01/2019
Last updated
04/11/2024
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