Provider Demographics
NPI:1467083154
Name:BROWN, ASHLEY KNICOLE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:KNICOLE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:KNICOLE
Other - Last Name:HARREL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 12427
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32317-2427
Mailing Address - Country:US
Mailing Address - Phone:850-297-0114
Mailing Address - Fax:850-297-0314
Practice Address - Street 1:1961 BUFORD BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4466
Practice Address - Country:US
Practice Address - Phone:850-216-2977
Practice Address - Fax:850-877-2983
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11005722363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner