Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 1-137810 | AL |
N | 363LW0102X | Nurse Practitioner - Women's Health | 903264 | MS |
NPI | 1023577624 |
---|---|
Provider Name | Kristen Nicole Scarborough Dhawan |
First Address | Mobile, AL 36609-5503 |
Second Address | Mobile, AL 36609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2019 |
Last Update Date | 02/12/2019 |