Provider Demographics
NPI:1649542572
Name:GURLEY, BROOKE K (CRNA)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:K
Last Name:GURLEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:B
Other - Last Name:KESLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 7297
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30604-7297
Mailing Address - Country:US
Mailing Address - Phone:706-543-3449
Mailing Address - Fax:706-543-5744
Practice Address - Street 1:1230 BAXTER ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-3712
Practice Address - Country:US
Practice Address - Phone:706-543-3449
Practice Address - Fax:706-543-5744
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN197240367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered