Individual
NICOLE S FENNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 712-3635
(334) 699-4387
Mailing address
PO BOX 1928, DOTHAN, AL 36301-3022
(334) 712-3635
(334) 699-4387
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-120271
AL
363L00000X
Nurse Practitioner
ARNP9382028
FL
Other
Enumeration date
08/20/2014
Last updated
01/04/2016
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