Brandi  N  Duhaime Bowden    CRNP
Contract Details
Enterprise Express Care
Facility name
Provider ID
P000007713
NPI
1811251010
Tax ID
271826294
Effective Date
2/1/2014
Last Updated
3/5/2015
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
F
Fee Schedule Name
106.00
Fee Schedule Multiplier
Location Details
Address
805 East Lee Street Suite C
Enterprise, AL 36330
United States
County
Coffee
Phone
3343488818 (Phone)
Billing Details
Address
P.O. Box 9395
Belfast, ME 04915
Billing Phone
3343488818
Specialty Type
Nurse Practitioner
Map
Address