Individual
KATHLEEN MENDHEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
287 HEALTHWEST DR, DOTHAN, AL 36303-2031
(334) 792-9500
(334) 793-1815
Mailing address
287 HEALTHWEST DR, DOTHAN, AL 36303-2031
(334) 792-9500
(334) 793-1815
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-110354
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-110354
ALABAMA NURSING LICENSE
AL
01
—
511-57583
BC/BS AL
AL
01
—
511-57591
BC/BS AL
AL
Enumeration date
09/12/2012
Last updated
04/30/2017
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