Individual
JAMILLIA RENEA SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2731 MARTIN LUTHER KING BLVD, TUSCALOOSA, AL 35401-5235
(205) 758-6647
Mailing address
2801 15TH AVE, NORTHPORT, AL 35476-3243
(205) 331-8464
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-172032
AL
Other
Enumeration date
10/16/2023
Last updated
10/17/2023
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