Provider Demographics
NPI:1104261973
Name:MCLEOD SAIZAN, JENNIFER NICOLE (AGNP-C)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:NICOLE
Last Name:MCLEOD SAIZAN
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:NICOLE
Other - Last Name:MCLEOD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 MOBILE INFIRMARY CIR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3520
Mailing Address - Country:US
Mailing Address - Phone:251-433-3344
Mailing Address - Fax:251-433-4052
Practice Address - Street 1:2 CHASE CORPORATE DR STE 300
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-1015
Practice Address - Country:US
Practice Address - Phone:312-262-2739
Practice Address - Fax:312-564-4059
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR893592363LA2200X
AL1-111203363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health