Provider Demographics
NPI:1134466618
Name:DOOLEY-SPEEGLE, AMY (CRNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DOOLEY-SPEEGLE
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 1:416 N SEMINARY ST
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4688
Mailing Address - Country:US
Mailing Address - Phone:256-766-8667
Mailing Address - Fax:256-767-5327
Practice Address - Street 1:416 N SEMINARY ST
Practice Address - Street 2:SUITE 3100
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4688
Practice Address - Country:US
Practice Address - Phone:256-766-8667
Practice Address - Fax:256-767-5327
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-070801363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1134466618Medicaid
AL1134466618Medicaid