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NPI Code Detail

MEDICARE: AUDREA ANNETTE DOOLEY CRNP

MEDICARE: AUDREA ANNETTE DOOLEY CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner1-087258AL

General Provider Information

NPI Number : 1396070835
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDREA ANNETTE DOOLEY CRNP
Provider Business Mailing Address
First Line : 101E 15TH AVE
Second Line :
City : GULF SHORES
State : AL
Zip : 36542-3501
Country : US
Telephone Number : 251-962-1250
Fax Number : 251-962-3095
Provider Business Practice Location Address
First Line : 101E 15TH AVE
Second Line :
City : GULF SHORES
State : AL
Zip : 36542-3501
Country : US
Telephone Number : 251-962-1250
Fax Number : 251-962-3095
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2009
Last Update Date : 02/22/2016

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