=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326951484
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GARI ASHLI BROOKE LYLE RN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/28/2026
-----------------------------------------------------
Last Update Date | 09/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1105 EARL FRYE BLVD
-----------------------------------------------------
City | AMORY
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38821-5500
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-315-0011
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 112 PECAN ORCHARD LN
-----------------------------------------------------
City | AMORY
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38821-2613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-315-0011
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 163WE0003X
-----------------------------------------------------
Taxonomy Name | Emergency Registered Nurse
-----------------------------------------------------
License Number | 912788
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------