Healthcare Provider Details

I. General information

NPI: 1710753876
Provider Name (Legal Business Name): REMONICA THURMOND PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2023
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 PLANTATION BLVD
FAIRHOPE AL
36532-3147
US

IV. Provider business mailing address

911 PLANTATION BLVD
FAIRHOPE AL
36532-3147
US

V. Phone/Fax

Practice location:
  • Phone: 877-850-7236
  • Fax:
Mailing address:
  • Phone: 877-850-7236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number906415
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3-0011659
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: