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SENIOR HEALTH SOURCE LLC NPI 1750677407


NPI Information

NPI: 1750677407
Provider Name: SENIOR HEALTH SOURCE LLC
Classification: Clinical Nurse Specialist - 364SG0600X
Entity Type: Organization

Specialization: Gerontology

Address:
27440 COUNTY ROAD 13
DAPHNE, AL
ZIP 36526
Phone: (251) 533-6372
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SENIOR HEALTH SOURCE LLC is a gerontology clinical nurse specialist in Daphne, AL. SENIOR HEALTH SOURCE LLC NPI is 1750677407. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

27440 COUNTY ROAD 13
DAPHNE, AL
ZIP 36526-222
Phone: (251) 533-6372

The provider's authorized official is Karen L Jackson .
The authorized official title is Owner and has the following contact phone number (251) 533-6372.

The enumeration date for this NPI number is 6/21/2011 and was last updated on 12/30/2011.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1364SG0600XClinical Nurse SpecialistGerontology1-087343ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1102G705926MEDICARE UPINALABAMA

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: 11/14/2023

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