Individual
MS. TINA MARIE MAULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(334) 255-7741
Mailing address
301 ANDREWS AVE, FORT RUCKER, AL 36362
(334) 255-7741
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1-126836
AL
164W00000X
Licensed Practical Nurse
2-041622
AL
Other
Enumeration date
02/14/2008
Last updated
09/21/2011
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