Individual
MRS. AUDREA H MISSILDINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1031 COUNTY ROAD 114, JACK, AL 36346-6264
(334) 853-0177
(334) 853-0178
Mailing address
1031 COUNTY ROAD 114, JACK, AL 36346-6264
(334) 853-0177
(334) 853-0178
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-065276
AL
Other
Enumeration date
08/11/2010
Last updated
07/12/2019
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