Provider Demographics
NPI:1467856591
Name:BRALEY, AYLA LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:AYLA
Middle Name:LYNN
Last Name:BRALEY
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:AYLA
Other - Middle Name:LYNN
Other - Last Name:CLEVENGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:785 5TH AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4218
Practice Address - Street 1:1610 ORCHARD DR
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-9206
Practice Address - Country:US
Practice Address - Phone:717-261-0929
Practice Address - Fax:717-261-0902
Is Sole Proprietor?:No
Enumeration Date:2014-10-17
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASPS014318363L00000X
PASP014318363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102966498Medicaid
12759937OtherCAQH
PAP01588647Medicare PIN