Individual
MRS. TABITHA T CLEMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
104A PHYSICIANS DR, MUSCLE SHOALS, AL 35661-2100
(256) 383-6070
(256) 383-6022
Mailing address
PO BOX 298, FLORENCE, AL 35631-0298
(256) 767-7494
(256) 765-0377
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1-064309
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165208
—
AL
01
—
515-94854
BCBS
—
01
—
I067
MEDICARE
AL
Enumeration date
05/23/2007
Last updated
08/28/2019
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