| Organization Name: | STATE OF ALABAMA DEPARTMENT OF PUBLIC HEALTH |
| NPI Number: | 1275842130 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JANICE R. MCINNIS (NURSE PRACTITIONER) |
| Mailing Address: | 1850 Crawford Rd Phenix City |
| State: | AL US |
| Postal Code: | 368670548 |
| Phone Number: | 3342970251 |
| Fax Number: | 3342915478 |
| NPI Enumeration Date: | 09/27/2010 |
| NPI Last Update Date: | 09/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 1-017420 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |