Provider Demographics
NPI:1205469517
Name:CRISLER, BROOKLYN (FNP-C)
Entity type:Individual
Prefix:
First Name:BROOKLYN
Middle Name:
Last Name:CRISLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2353 BENT CREEK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-6482
Mailing Address - Country:US
Mailing Address - Phone:334-887-8707
Mailing Address - Fax:
Practice Address - Street 1:2353 BENT CREEK RD STE 110
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-6482
Practice Address - Country:US
Practice Address - Phone:334-887-8707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184712363L00000X
AL3-000521363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner