| Jennivie Shaunette Latham-hickman, FAMILY NP | |
|
101 Westover Cir, Suite A, Madison, AL 35758-4900 | |
| (256) 461-0209 | |
| (256) 325-3147 |
| Full Name | Jennivie Shaunette Latham-hickman |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 101 Westover Cir, Madison, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962747071 | NPI | - | NPPES |
| 148215 | Medicaid | AL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 1-098043 (Alabama) | Primary |
| Entity Name | Fast Pace Medical Clinic Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639679962 PECOS PAC ID: 5395881841 Enrollment ID: O20200415001560 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennivie Shaunette Latham-hickman, FAMILY NP 101 Westover Cir, Suite A, Madison, AL 35758-4900 Ph: (256) 461-0209 | Jennivie Shaunette Latham-hickman, FAMILY NP 101 Westover Cir, Suite A, Madison, AL 35758-4900 Ph: (256) 461-0209 |
Krista Young, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 600 Sun Temple Dr, Madison, AL 35758 Phone: 256-975-4291 Fax: 256-288-3334 | |
Dr. Kaitlyn Wendolowski, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 12100 County Line Rd Ste A2, Madison, AL 35756 Phone: 256-724-7714 Fax: 256-724-7065 | |
Natalie R Baker, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 12205 County Line Rd, Suite B, Madison, AL 35758 Phone: 256-325-4365 Fax: 256-461-0393 | |
Chastity D Ayers, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 600 Sun Temple Dr, Madison, AL 35758 Phone: 256-288-3333 Fax: 256-288-3334 | |
Mr. Blake Hamilton Gilliam, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1230 Slaughter Rd Ste C, Madison, AL 35758 Phone: 256-325-0955 | |
Mrs. Ruth Morris Church, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8216 Madison Blvd, Madison, AL 35758 Phone: 256-464-9991 Fax: 256-464-9994 | |
Erin Stinnett, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 7500 Highway 72 W, Madison, AL 35758 Phone: 256-964-8338 |