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Individual

BONNIE DIANE PICKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
12701 PADGETT SWITCH RD, IRVINGTON, AL 36544-4011
(251) 824-2174
(251) 824-2286
Mailing address
1209 BIENVILLE BLVD, DAUPHIN ISLAND, AL 36528-4359
(251) 214-6119

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-158008
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
345214
AL
01
513-27535
BCBS
AL
Enumeration date
10/26/2023
Last updated
04/23/2026
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