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Individual

JAKE PICKENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNP

Contact information

Practice address
1728 11TH AVE, HALEYVILLE, AL 35565-1506
(205) 485-7822
(833) 449-4072
Mailing address
1728 11TH AVE, HALEYVILLE, AL 35565-1506
(205) 485-7822
(833) 449-4072

Taxonomy

Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
1-170309
AL
363L00000X
Nurse Practitioner
Primary
1-170309
AL

Other

Enumeration date
12/19/2023
Last updated
01/12/2024
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