DYLAN REESE MCCOLLOUGH (NPI# 1285250670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285250670 |
Entity Type | Individual |
Full Name | DYLAN REESE MCCOLLOUGH |
Credential | CRNP |
Practice Address |
6582 Boll Weevil Cir Enterprise AL 36330-9424 |
Mailing Address |
9631 Highway 125 Elba AL 36323-7769 |
Practice Telephone | 3343472027 |
Enumeration Date | 2020-06-22 |
Last Update Date | 2020-06-22 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1-140157 | AL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
6582 BOLL WEEVIL CIR |
City | ENTERPRISE |
State | AL |
Zip Code | 36330-9424 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831658350 | Enterprise Urgent Care | Family Medicine | 6582 Boll Weevil Cir, Enterprise, AL 36330-9424 | 2019-03-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417566860 | Julia Brooke Lowe | Pharmacist | 847 Boll Weivell Circle #112, Enterprise, AL 36330 | 2020-07-30 |
1134759640 | Benjamin Chase Marler | Student in an Organized Health Care Education/Training Program | 205 Somerset Pl, Enterprise, AL 36330 | 2020-01-23 |
1033694492 | Angel Melton | Counselor | 105 Searcy St, Enterprise, AL 36330 | 2018-10-01 |
1285180729 | Enterprise Urgent Care | Clinic/Center | 6582 Boll Weevil Circle, Enterprise, AL 36330 | 2016-08-25 |
1902204258 | Nikki Chen | Nurse Practitioner | 805 East Lee Street, Ste C, Enterprise, AL 36330 | 2014-12-17 |
1568795417 | Crystal Juanita Christian | Counselor | 1275 James Drive, Suite A Enterprise Behavioral Services, Enterprise, AL 36330 | 2009-09-10 |
1316173206 | Robert Noback | Preventive Medicine | 301 Dustoff Ave, Ft. Rucker, AL 36330 | 2009-06-05 |
1184892978 | Phillip Allen Fuller | Pulmonary Function Technologist | 130e.pondella Dr., Enterprise, AL 36330 | 2008-02-14 |
1720266778 | Richard Bauer | Emergency Medical Technician, Intermediate | Bld 301 Andrews Ave., Lyster Army Health Clinic, Ft Rucker, AL 36330 | 2008-02-01 |
1871646547 | Thomas Orson Patterson | Dentist | 306 South Edwards Street, Enterprise, AL 36330 | 2007-01-18 |
Find all providers in zip 36330 |
Taxonomy Code | 363LF0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811514722 | Susan Maxine Wagner | Nurse Practitioner | 103 Hilton Cir, Enterprise, AL 36330-7815 | 2020-06-26 |
1336669472 | Jennifer Stewart | Nurse Practitioner | 114 Flatrock Dr, Enterprise, AL 36330-4457 | 2017-06-20 |
1528424215 | Affordable Integrated Medicine | Nurse Practitioner | 610 W North St Ste B, Enterprise, OR 97828-1427 | 2016-01-11 |
1689001596 | Abby Spitler Olive | Nurse Practitioner | 606 Boll Weevil Cir, Suite A, Enterprise, AL 36330-2734 | 2013-10-09 |
1154629178 | Ashley D Gray | Nurse Practitioner | 83a Old Mill Creek Rd, Enterprise, MS 39330-9649 | 2011-03-01 |
1447219886 | Michelle Diane Stewmon | Nurse Practitioner | 103 W Robertson Ct, Enterprise, AL 36330-2344 | 2006-03-23 |
1629061981 | Theresa A Russell | Nurse Practitioner | 406 Ne 1st St, Enterprise, OR 97828-1168 | 2005-08-23 |
1063925626 | Jessica E Poitevint | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2017-11-06 |
1063956233 | Millicent R Harrison | Nurse Practitioner | 105 E Watts St, Enterprise, AL 36330-2511 | 2016-12-07 |
1811449812 | Hannah Elizabeth Mcqueen | Nurse Practitioner | 101 E Brunson St Ste 200, Enterprise, AL 36330-2500 | 2016-10-26 |
Find all providers in ENTERPRISE |
City | ENTERPRISE |
Zip Code | 36330 |
Please comment or provide details below to improve the information on DYLAN REESE MCCOLLOUGH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.