Provider Demographics
NPI:1144728262
Name:CHANEY, JESSALYN HARRELSON (CRNP)
Entity type:Individual
Prefix:
First Name:JESSALYN
Middle Name:HARRELSON
Last Name:CHANEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 LIME CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:AL
Mailing Address - Zip Code:35043-5586
Mailing Address - Country:US
Mailing Address - Phone:256-749-8497
Mailing Address - Fax:
Practice Address - Street 1:1802 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1932
Practice Address - Country:US
Practice Address - Phone:205-934-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-145147363LA2100X
AL1145147363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care