Healthcare Provider Details

I. General information

NPI: 1013551811
Provider Name (Legal Business Name): ELIZABETH ANN MCFARLAND CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 05/20/2020
Certification Date: 05/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 HAVEN DR
DOTHAN AL
36301-2919
US

IV. Provider business mailing address

207 HAVEN DR
DOTHAN AL
36301-2919
US

V. Phone/Fax

Practice location:
  • Phone: 334-793-3319
  • Fax: 334-793-2291
Mailing address:
  • Phone: 334-793-3319
  • Fax: 334-793-2291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-147413
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: