Healthcare Provider Details

I. General information

NPI: 1720761505
Provider Name (Legal Business Name): AUBREY BREWER HARVELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3719 DAUPHIN ST
MOBILE AL
36608-1753
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-344-9630
  • Fax:
Mailing address:
  • Phone: 866-401-3057
  • Fax: 318-868-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.2453
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: