Organization
VALLEY FAMILY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA RAE DICKERSON CRNP (NURSE PRACTITIONER)
(256) 651-3062
Entity
Organization
Contact information
Practice address
12060 COUNTY LINE RD, SUITE D, MADISON, AL 35756-2003
(256) 651-3062
Mailing address
12060 COUNTY LINE RD, SUITE D, MADISON, AL 35756-2003
(256) 651-3062
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
1-093181
AL
363LF0000X
Family Nurse Practitioner
Primary
1-093181
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110708
—
AL
Enumeration date
11/08/2011
Last updated
11/08/2011
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