Healthcare Provider Details

I. General information

NPI: 1619600103
Provider Name (Legal Business Name): DENA BIVIN YEARWOOD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2022
Last Update Date: 07/02/2022
Certification Date: 07/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 ALISON DR STE 8
ALEXANDER CITY AL
35010-4410
US

IV. Provider business mailing address

1026 EDGEWATER LN
CHELSEA AL
35043-2000
US

V. Phone/Fax

Practice location:
  • Phone: 256-409-2159
  • Fax: 256-409-2178
Mailing address:
  • Phone: 205-915-8694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-083902
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: