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Individual

JACQUITA L SAMECK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C.R.N.P.

Contact information

Practice address
910 ADAMS ST SE, SUITE 300, HUNTSVILLE, AL 35801-3730
(256) 533-7420
(256) 536-4109
Mailing address
910 ADAMS ST SE, SUITE 300, HUNTSVILLE, AL 35801-3730
(256) 533-7420
(256) 536-4109

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
1-035752
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
51076937
BCBS
AL
01
D084
MEDICARE
AL
01
E709
MEDICARE
AL
01
G423
MEDICARE
AL
Enumeration date
02/01/2007
Last updated
10/30/2007
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