Jaylen Alonzo Ferguson
Student in an Organized Health Care Education/Training Program in Birmingham, AL. Individual provider (NPI-1).
NPI number1467358168
StatusActive
Last updated in NPPESOct 19, 2026
Details
- NPI
- 1467358168
- Entity type
- Individual (NPI-1)
- Name
- Jaylen Alonzo Ferguson
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 19, 2026
- Certification date
- Oct 19, 2026
- Last updated
- Oct 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | s14998 | AL | Yes |
Practice location
800 Lakeshore DrBirmingham, AL 35229-0001
Phone 205-726-4883
Mailing address
201 Kenniston DlPelham, AL 35124-6254
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