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General NPI Number Information
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NPI Number | 1184981359
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Entity Type | Individual
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Provider Name | ASHLEY BRANTLEY MOELLINGER CRNP
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Gender | Female
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 619 19TH ST S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1900
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Country | US
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Telephone | 205-934-4206
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Fax |
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Provider Business Mailing Address
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Address Line | 912 VESTLAKE HOLLOW CIR
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City | VESTAVIA
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State | AL
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Zip | 35242-7513
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Country | US
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Telephone | 205-969-2724
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0222X
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Taxonomy Name | Critical Care Pediatric Nurse Practitioner
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License Number | 1-084516
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License Number State | AL
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