Provider Demographics
NPI:1396070835
Name:DOOLEY, AUDREA ANNETTE (CRNP)
Entity type:Individual
Prefix:
First Name:AUDREA
Middle Name:ANNETTE
Last Name:DOOLEY
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 1:101E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-3501
Mailing Address - Country:US
Mailing Address - Phone:251-962-1250
Mailing Address - Fax:251-962-3095
Practice Address - Street 1:101E 15TH AVE
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-3501
Practice Address - Country:US
Practice Address - Phone:251-962-1250
Practice Address - Fax:251-962-3095
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2016-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-087258363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner