Individual
NIDRA WILSON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
385 E LAFAYETTE ST, DADEVILLE, AL 36853-1415
(256) 825-9244
Mailing address
1406 BITTERNE CT, OPELIKA, AL 36804-3409
(256) 604-6522
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023006483
AL
Other
Enumeration date
01/02/2024
Last updated
01/02/2024
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