Provider Demographics
NPI:1730725508
Name:PARKER, ASHLEY BROOKE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:BROOKE
Last Name:PARKER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36312-4507
Mailing Address - Country:US
Mailing Address - Phone:334-701-8967
Mailing Address - Fax:
Practice Address - Street 1:1118 ROSS CLARK CIR STE 303
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-3034
Practice Address - Country:US
Practice Address - Phone:334-794-3192
Practice Address - Fax:877-553-0033
Is Sole Proprietor?:No
Enumeration Date:2019-11-26
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-117514363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51244485OtherBCBS AL