Individual
DEDRA L CAPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
504 MCCURDY AVE SOUTH, SUITE, RAINSVILLE, AL 35986-5254
(256) 638-9161
(256) 638-9164
Mailing address
PO BOX 649, RAINSVILLE, AL 35986-0649
(256) 638-9161
(256) 638-9164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1-093350
AL
363LF0000X
Family Nurse Practitioner
1-093350
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO6289
RR MEDICARE
—
01
—
P00695177
RR MEDICARE
AL
Enumeration date
09/25/2006
Last updated
06/18/2014
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