Healthcare Provider Details

I. General information

NPI: 1316223027
Provider Name (Legal Business Name): WASHINGTON COUNTY HEALTHCARE AUTHORITY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2011
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 LONG STREET
MILLRY AL
36558
US

IV. Provider business mailing address

PO BOX 1299
CHATOM AL
36518-1299
US

V. Phone/Fax

Practice location:
  • Phone: 251-846-3233
  • Fax: 251-846-3224
Mailing address:
  • Phone: 251-847-2223
  • Fax: 251-847-3808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LESLEY JEAN DUNN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 251-847-2223