Mrs Audrea H Missildine, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Jack, Alabama. Her current practice location is
1031 County Road 114, Jack, Alabama. You can reach out to her office (for appointments etc.) via phone at
(334) 853-0177.
Mrs Audrea H Missildine is licensed to practice in Alabama (license number 1-065276) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083929376.
Provider's Profile
Full Name | Mrs Audrea H Missildine |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 1031 County Road 114, Jack, Alabama |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1083929376
- Provider Enumeration Date: 08/11/2010
- Last Update Date: 07/12/2019
Medicare PECOS Information:
- PECOS PAC ID: 7517148299
- Enrollment ID: I20150120001775
Medical Identifiers
Medical identifiers for Mrs Audrea H Missildine such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083929376 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 1-065276 (Alabama) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Audrea H Missildine is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Audrea H Missildine, CRNP 1031 County Road 114, Jack, AL 36346-6264 Ph: (334) 853-0177 | Mrs Audrea H Missildine, CRNP 1031 County Road 114, Jack, AL 36346-6264 Ph: (334) 853-0177 |
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