Basic Information
Provider Information
NPI: 1003015678
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CURRIE
FirstName: JENNIFER
MiddleName: SHANA DIAMOND
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 40480
Address2:  
City: MOBILE
State: AL
PostalCode: 366400480
CountryCode: US
TelephoneNumber: 2514705842
FaxNumber: 2514705809
Practice Location
Address1: 1504 SPRINGHILL AVE
Address2: SUITE 1600
City: MOBILE
State: AL
PostalCode: 366043207
CountryCode: US
TelephoneNumber: 2514343915
FaxNumber: 2514343802
Other Information
ProviderEnumerationDate: 07/13/2007
LastUpdateDate: 09/02/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XDO.1032ALY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


Home