Individual
MADISON WHITLEY RIVENBARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1118 ROSS CLARK CIR, DOTHAN, AL 36301-3001
(334) 712-3738
(334) 699-4897
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 790-9933
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-145217
AL
Other
Enumeration date
09/13/2017
Last updated
01/17/2024
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