Organization
DOCNURSEMHC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRY GORMAN CRNP (CRNP)
(205) 475-3908
Entity
Organization
Contact information
Practice address
165 E HAWTHORNE AVE, COLVILLE, WA 99114-2629
(205) 475-3908
Mailing address
6718 RIDGECREST CIR, MC CALLA, AL 35111-3960
(205) 475-3908
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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