| Mrs Jessica Nicole Wisdom, CRNP | |
| 201 Doctors Dr, Dothan, AL 36301-2949 | |
| (334) 794-6611 | |
| Not Available | 
| Full Name | Mrs Jessica Nicole Wisdom | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner - Family | 
| Location | 201 Doctors Dr, Dothan, Alabama | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1811628639 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 169890 (Alabama) | Primary | 
| Entity Name | Southern Clinic Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053410480 PECOS PAC ID: 1355329269 Enrollment ID: O20040708000585 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Jessica Nicole Wisdom, CRNP 1601 Tacoma St, Dothan, AL 36303-3273 Ph: (334) 797-8573 | Mrs Jessica Nicole Wisdom, CRNP 201 Doctors Dr, Dothan, AL 36301-2949 Ph: (334) 794-6611 | 
| Julia Jones Holloway,  Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1812 E Main St, Dothan, AL 36301 Phone: 334-792-5184 Fax: 334-792-5190 | |
| Heather Young, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 480 Honeysuckle Rd, Dothan, AL 36305 Phone: 334-836-1212 | |
| Jenna Oates, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 287 Healthwest Dr, Dothan, AL 36303 Phone: 334-792-9500 | |
| Mrs. Samantha Poole Carter, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 W Main St Ste 15, Dothan, AL 36305 Phone: 334-944-7056 Fax: 334-944-7063 | |
| Elizabeth Ann Mcfarland, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 207 Haven Dr, Dothan, AL 36301 Phone: 334-793-3319 Fax: 334-793-2291 | |
| Amanda B Imming, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1901 Melba Drive, Dothan, AL 36301 Phone: 334-794-6611 Fax: 334-794-6614 | |
| Vickie D Sconyers, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4300 West Main St, Womens Healthcare Of Dothan Pc Ste 31, Dothan, AL 36305 Phone: 334-793-6511 Fax: 334-677-5642 |