| NPI | 1558648311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA RAE DICKERSON Nurse Practitioner 256-651-3062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-093181) |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health (Licence: AL 1-093181) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |