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Individual

MS. MAUREEN FRANCES VIDRINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-PMH

Contact information

Practice address
10385 HWY 278, COVINGTON, GA 30014
(770) 784-9777
Mailing address
880 BETHEL CHURCH RD, MONROE, GA 30655-8109
(770) 784-9777

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN076382
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN076382
GA
364S00000X
Clinical Nurse Specialist
RN076382
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019589102
ANCC CNS
Enumeration date
12/04/2006
Last updated
08/06/2016
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