Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Jessie Leyla Blackmon, CRNP

Individual provider Registered Nurse · NPI 1811460173

Mrs. Jessie Leyla Blackmon, CRNP is a Nurse Practitioner in Vestavia Hls, Alabama. Qualified in 2020, 6 years ago. Practices with Aqua Dermatology of Alabama PC, a 42-clinician group and accepts Medicare assignment. Licensed in Alabama.

Years since qualifying
6
Licensed in
AL
In the registry since
2019
Specialties on file
2
What do these letters mean?
CRNP — Certified Registered Nurse Practitioner
The title Pennsylvania and some other states use for a nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

1940 Stonegate Dr Ste 130
Vestavia Hls, AL 35242-2541
Phone: (205) 977-9876
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence F09201154 (AL)
Registered Nurse Taxonomy 163W00000X · Licence 1-162172 (AL)

Record details

NPI number1811460173
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNP
Sole proprietorYes
NPI enumeratedJanuary 9, 2019
Last updated in NPPESJanuary 22, 2022
Certification dateJanuary 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Aqua Dermatology Of Alabama Pc — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount