Provider Demographics
NPI:1790276012
Name:MCLEAN, ASHLEY C MERCHANT (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C MERCHANT
Last Name:MCLEAN
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 1:8681 HAMBY RD
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:AL
Mailing Address - Zip Code:35116-2207
Mailing Address - Country:US
Mailing Address - Phone:334-401-0173
Mailing Address - Fax:
Practice Address - Street 1:3400 HIGHWAY 78 E
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-8956
Practice Address - Country:US
Practice Address - Phone:205-387-4961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-22
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-144712363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily