Provider Demographics
NPI:1689566903
Name:WURL, BROOKLYN TAYLOR (CRNA)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:TAYLOR
Last Name:WURL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BROOKLYN
Other - Middle Name:TAYLOR
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 E LAKESHORE DR SE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-5917
Mailing Address - Country:US
Mailing Address - Phone:423-827-8927
Mailing Address - Fax:
Practice Address - Street 1:501 REDMOND RD NW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-1415
Practice Address - Country:US
Practice Address - Phone:706-291-0291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN338828367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered