Individual
GWEN BONITA MALONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
200 UNIVERSITY BLVD, TUSCALOOSA, AL 35402-0707
(205) 759-0633
(205) 759-0635
Mailing address
PO BOX 21231, 200 UNIVERSITY BLVD, TUSCALOOSA, AL 35402-0707
(205) 759-0633
(205) 759-0635
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1044329
AL
Other
Enumeration date
09/16/2006
Last updated
07/08/2007
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