Provider Demographics
NPI:1235924077
Name:MERRICK, ASHLEY BROOKE
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:MERRICK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 N HERITAGE DR
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37803-6412
Mailing Address - Country:US
Mailing Address - Phone:931-267-2121
Mailing Address - Fax:
Practice Address - Street 1:1122 N HERITAGE DR
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37803-6412
Practice Address - Country:US
Practice Address - Phone:931-267-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-11
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider