Individual
KELSEY C JACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
116 GRANT CIR, CALERA, AL 35040-5574
(205) 617-4010
Mailing address
116 GRANT CIR, CALERA, AL 35040-5574
(205) 617-4010
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1161964
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/27/2021
Last updated
08/08/2024
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