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Contact Information

DEIRDRE M AYCOCK, CRNP
45 INDUSTRIAL DR W
PINE HILL, AL36769-3369
 Phone: 334-963-2113
 Fax: 334-963-2116
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for DEIRDRE M AYCOCK · (Female)

NPI # 1588927453
Status Active
Credentials CRNP (Certified Registered Nurse Practitioner)
Entity Individual
Enumeration date 06/16/2012
Last updated 07/21/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • AL License # 1-053747
  • AL Medicaid 180596
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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