Provider Demographics
NPI:1992542492
Name:BROOKS, ASHLEY DELONEY (CRNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DELONEY
Last Name:BROOKS
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 1:732 MERRIWEATHER RD
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-9316
Mailing Address - Country:US
Mailing Address - Phone:334-432-0428
Mailing Address - Fax:
Practice Address - Street 1:142 W 3RD ST
Practice Address - Street 2:
Practice Address - City:LUVERNE
Practice Address - State:AL
Practice Address - Zip Code:36049-1348
Practice Address - Country:US
Practice Address - Phone:205-343-7300
Practice Address - Fax:205-343-7306
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-198893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1-198893OtherLICENSE