| Nicole M Laird Crnp | |
|
106 Edwina St Evergreen AL 36401-3319 | |
| (251) 578-4300 | |
| (251) 578-4307 |
| Full Name | Nicole M Laird Crnp |
|---|---|
| Speciality | Internal Medicine |
| Location | 106 Edwina St, Evergreen, Alabama |
| Authorized Official Name and Position | Sharon Jones (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2515782480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole M Laird Crnp 106 Edwina St Evergreen AL 36401-3319 Ph: (251) 578-4300 | Nicole M Laird Crnp 106 Edwina St Evergreen AL 36401-3319 Ph: (251) 578-4300 |
| NPI Number | 1891904223 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 04/20/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891904223 | NPI | - | NPPES |
| 529933018 | Other | AL | MEDICAID PAYEE |
| 529906180 | Other | AL | MEDICAID GROUP PAYEE NUMB |
| 510G700111 | Other | AL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 19723 (Alabama) | Secondary |
| 207R00000X | Internal Medicine | H1801 (Alabama) | Primary |
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Evergreen Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 100 Edwina Street, Evergreen, AL 36401 Phone: 251-578-0278 Fax: 251-578-0290 | |
Helen Scharko, M.d. , Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 102 Edwina St, Evergreen, AL 36401 Phone: 251-578-0220 Fax: 251-578-0223 | |
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