Provider Demographics
NPI:1942941497
Name:BRUMLEY, ALICE W (DNP)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:W
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
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Mailing Address - Street 1:21575 KAPOK CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3718
Mailing Address - Country:US
Mailing Address - Phone:561-462-0622
Mailing Address - Fax:
Practice Address - Street 1:777 GLADES RD BLDG AZ-79
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6424
Practice Address - Country:US
Practice Address - Phone:561-297-0502
Practice Address - Fax:561-297-0505
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-06
Last Update Date:2024-03-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11015184363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty