Individual
AUSTIN WYATT BIVINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4370 W MAIN ST, DOTHAN, AL 36305-4000
(334) 793-5000
Mailing address
413 BURT DR APT 7, DOTHAN, AL 36305-1161
(317) 735-5567
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-151891
AL
Other
Enumeration date
05/31/2019
Last updated
05/31/2019
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