Provider Demographics
NPI:1174058432
Name:HALL, ASHLEY I (CRNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:I
Last Name:HALL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:1595 E MAIN ST
Practice Address - Street 2:
Practice Address - City:PRATTVILLE
Practice Address - State:AL
Practice Address - Zip Code:36066-5509
Practice Address - Country:US
Practice Address - Phone:334-361-7306
Practice Address - Fax:334-361-8966
Is Sole Proprietor?:No
Enumeration Date:2017-04-25
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-105950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL6017931OtherAETNA
AL213332Medicaid
AL512-05543OtherBCBS OF ALABAMA
ALZ51091OtherVIVA HEALTH
ALA00133K874OtherMEDICARE