Provider Demographics
NPI:1730466798
Name:CARR SCOGGINS, ASHLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CARR SCOGGINS
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 1:117 2ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35055-3511
Mailing Address - Country:US
Mailing Address - Phone:256-291-8877
Mailing Address - Fax:833-319-3812
Practice Address - Street 1:117 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35055-3511
Practice Address - Country:US
Practice Address - Phone:256-291-8877
Practice Address - Fax:833-319-3812
Is Sole Proprietor?:No
Enumeration Date:2011-11-04
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102772363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL139449Medicaid