Provider Demographics
NPI:1538694971
Name:JENNINGS, CIERRA
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 INDUSTRIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35983-3737
Mailing Address - Country:US
Mailing Address - Phone:256-526-3323
Mailing Address - Fax:256-526-3324
Practice Address - Street 1:280 INDUSTRIAL BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:AL
Practice Address - Zip Code:35983-3737
Practice Address - Country:US
Practice Address - Phone:565-263-3232
Practice Address - Fax:256-526-3324
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1148600363LF0000X
AL1-148600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine