Individual
TERRICA DEAN VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
159 MAGNOLIA CREEK DR, COLUMBIANA, AL 35051-9457
(205) 784-5273
Mailing address
310 ALEXANDER ST, TALLADEGA, AL 35160-2625
(256) 375-5407
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-127995
AL
Other
Enumeration date
04/03/2019
Last updated
07/01/2024
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