Shjuan D Pickett-crockett, | |
1768 S Washington St, Marion, AL 36756-3406 | |
(334) 682-9085 | |
(334) 682-9082 |
Full Name | Shjuan D Pickett-crockett |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 1768 S Washington St, Marion, Alabama |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1619371614 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 1-113983 (Alabama) | Primary |
Entity Name | Vaughan Regional Medical Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114088846 PECOS PAC ID: 0143134171 Enrollment ID: O20031114000230 |
Mailing Address | Practice Location Address |
---|---|
Shjuan D Pickett-crockett, 1768 S Washington St, Marion, AL 36756-3406 Ph: (334) 682-9086 | Shjuan D Pickett-crockett, 1768 S Washington St, Marion, AL 36756-3406 Ph: (334) 682-9085 |
Mrs. Cynthia Jackson Evans, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1303 Washington St, Marion, AL 36756 Phone: 334-247-1006 Fax: 334-683-5737 | |
Ashley Wagner, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1303 Washington St, Marion, AL 36756 Phone: 120-541-7705 | |
Mrs. Lora N. Mims, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Rr 2, Box 4d, Hwy 45 S, Marion, AL 36756 Phone: 334-683-9085 Fax: 334-683-9082 |