JERRY LADON OUTLAW CRNP NPI 1609125202

NPI Information

NPI: 1609125202
Provider Name: JERRY LADON OUTLAW, CRNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
145 KATHERINE AVE.
OZARK, AL
ZIP 36360
Phone: (334) 774-5116
Get Directions

Jerry Ladon Outlaw, CRNP is a family nurse practitioner in Ozark, AL. Jerry Ladon Outlaw, CRNP NPI is 1609125202. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

145 KATHERINE AVE.
OZARK, AL
ZIP 36360-987
Phone: (334) 774-5116
Fax: (334) 774-6848

The NPI 1609125202 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/29/2012 and was last updated on 8/29/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	1-070149	ALABAMA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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