=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427566009
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY DILL BROWN APRN- CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2018
-----------------------------------------------------
Last Update Date | 09/05/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2002 12TH AVE NW STE B
-----------------------------------------------------
City | ARDMORE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73401-1206
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-221-2022
-----------------------------------------------------
Fax | 580-221-2024
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10840 MAIN CAMP RD
-----------------------------------------------------
City | DAVIS
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73030-9405
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-328-6671
-----------------------------------------------------
Fax | 580-221-2024
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 220104
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------