Individual
JENNIFER K GLENN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
(205) 638-2953
(205) 638-3925
Mailing address
1600 7TH AVE S, BIRMINGHAM, AL 35233-1711
(205) 638-2953
(205) 638-3925
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1105856
KY
363L00000X
Nurse Practitioner
4540P
KY
363LP0200X
Pediatric Nurse Practitioner
Primary
1-149075
AL
363LP0200X
Pediatric Nurse Practitioner
20041080
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1105856
KY BD OF NURSING
KY
01
—
4540P
KENTUCKY BD OF NURSING
KY
05
—
78014917
—
KY
Enumeration date
10/11/2005
Last updated
03/17/2015
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