Individual
JENNA L GAUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
809 UNIVERSITY BLVD E, TUSCALOOSA, AL 35401-2029
(205) 759-7111
Mailing address
850 PETER BRYCE BLVD, TUSCALOOSA, AL 35401-7457
(205) 348-1770
(205) 348-1772
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-128666
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-128666
STATE LICENSE
AL
Enumeration date
04/18/2019
Last updated
04/18/2019
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