Provider Demographics
NPI:1881066264
Name:BOX, ANNA BROOKE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:BROOKE
Last Name:BOX
Suffix:
Gender:F
Credentials:CRNP
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Mailing Address - Street 1:PO BOX 2587
Mailing Address - Street 2:
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35662-2587
Mailing Address - Country:US
Mailing Address - Phone:256-381-5507
Mailing Address - Fax:256-275-3641
Practice Address - Street 1:1404 E AVALON AVE
Practice Address - Street 2:
Practice Address - City:TUSCUMBIA
Practice Address - State:AL
Practice Address - Zip Code:35674-1773
Practice Address - Country:US
Practice Address - Phone:256-981-5507
Practice Address - Fax:256-381-3760
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2016-02-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AL1102190363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1326373861OtherSHOALS PRIMARY CARE, LLC