Healthcare Provider Details

I. General information

NPI: 1437065513
Provider Name (Legal Business Name): YOLANDA TAWANDA MARIE MCBRIDE AGPCNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 BURBANK ST
DOTHAN AL
36303-1919
US

IV. Provider business mailing address

1204 BURBANK ST
DOTHAN AL
36303-1919
US

V. Phone/Fax

Practice location:
  • Phone: 334-791-3383
  • Fax:
Mailing address:
  • Phone: 334-791-3383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number1-153527
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: