Healthcare Provider Details

I. General information

NPI: 1831957505
Provider Name (Legal Business Name): ASHLYN GOODWIN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 ELMER J BISSELL RD
BIRMINGHAM AL
35243-2941
US

IV. Provider business mailing address

1913 OLD CREEK TRL
VESTAVIA HILLS AL
35216-2138
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-4949
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number1-176249
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: