EMILY BROOKE PETTIS (NPI# 1811390396) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811390396 |
| Entity Type | Individual |
| Full Name | EMILY BROOKE PETTIS |
| Credential | CRNP |
| Practice Address |
1118 Ross Clark Cir Ste 100 Dothan AL 36301-3023 |
| Practice Telephone | 3347941148 |
| Mailing Telephone | 3347941148 |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AG0114029 | AL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033190756 | Emily Morgan Pettis | Pharmacist | 250 Middle Creek Rd, Sevierville, TN 37862-3944 | 2005-11-09 |
| Street Address |
1118 ROSS CLARK CIR STE 100 |
| City | DOTHAN |
| State | AL |
| Zip Code | 36301-3023 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780218123 | Amber Stewart | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2020-02-25 |
| 1639700602 | Traci M Stafford | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2020-01-29 |
| 1568020949 | Alyse Marie Murkerson | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301-3023 | 2019-05-31 |
| 1235621384 | Victoria Nichole Hatcher | Nurse Practitioner | 1118 Ross Clark Cir Ste 100, Dothan, AL 36301 | 2018-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043862931 | Pharmacy Center South LLC | Pharmacy | 2826 Ross Clark Circle, Suite 103, Dothan, AL 36301 | 2019-07-11 |
| 1851879167 | Attallah Cotton | Social Worker | 101 Eastridge Dr, Dothan, AL 36301 | 2018-07-31 |
| 1225522709 | Nichole Johnson Prestwood | Nurse Practitioner | 2431 W Main St Ste 501, Dothan, AL 36301 | 2018-06-19 |
| 1750805818 | Kimberly Danielle Austin | Speech-Language Pathologist | 404 Darlington Cir, Dothan, AL 36301 | 2017-07-31 |
| 1952794885 | Lori P. Granberry | Pharmacist | 2131 Ross Clark Circle, Dothan, AL 36301 | 2015-03-17 |
| 1801286059 | Robert Cody Russell | Nurse Practitioner | 1118 Ross Clark Circle, Suite 100, Dothan, AL 36301 | 2015-01-27 |
| 1720407646 | Michael Kreger | Anesthesiology | 1118 Ross Clark Cir Ste 700, Dothan, AL 36301 | 2014-04-08 |
| 1063851277 | Carlos Stanford Clark II | Family Medicine | 201 Doctors Drive, Dothan, AL 36301 | 2013-06-20 |
| 1639489313 | Robert Fort Hambaugh Jr. | Specialist | 712 Woodland Drive, Dothan, AL 36301 | 2010-10-15 |
| 1588894976 | Atwill Lamar Miller Jr. | Urology | 1908 Fairview Avenue, Dothan, AL 36301 | 2009-07-20 |
| Find all providers in zip 36301 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676584 | Julie Danielle Laird | Nurse Practitioner | 453 Sandstone Dr, Dothan, AL 36303-7313 | 2020-07-06 |
| 1902122591 | Audrey Phillips Swanson | Nurse Practitioner | 3160 W Main St Ste 6, Dothan, AL 36305-1180 | 2010-04-08 |
| 1609049550 | Dana Michelle Scott | Nurse Practitioner | 480 Honeysuckle Road, Dothan, AL 36305-3001 | 2008-04-10 |
| 1154841831 | James Eric Goforth | Nurse Practitioner | 201 Doctors Dr, Dothan, AL 36301-2949 | 2017-06-22 |
| 1184090359 | Amy Roselius | Nurse Practitioner | 3124 Ross Clark Cir, Dothan, AL 36303-3038 | 2015-08-11 |
| 1083033286 | John Evans Jr. | Nurse Practitioner | 1118 Ross Clark Cir, Suite 100, Dothan, AL 36301-3001 | 2014-04-15 |
| 1184995292 | Jason Lee Cox | Nurse Practitioner | 4300 W Main St Ste 21, Dothan, AL 36305-1058 | 2012-01-20 |
| 1508957499 | Melissa Ann Taylor | Nurse Practitioner | 2020 Alexander Dr, Dothan, AL 36301-3004 | 2006-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386250249 | Marnita Monique Stallworth | Nurse Practitioner | 3937 Harmony Ridge Cir W, Semmes, AL 36575-5282 | 2020-09-16 |
| 1619591468 | Cartney Michelle Kesten | Nurse Practitioner | 14006 Percivale Dr Se, Huntsville, AL 35803-1868 | 2020-06-07 |
| 1235764069 | Bianca A Norris | Nurse Practitioner | 7000 Adventist Blvd Nursing Department, Huntsville, AL 35896-0001 | 2020-03-12 |
| 1881227197 | Lavern Snow | Nurse Practitioner | 1108 45th Street Ensley, Birmingham, AL 35208-1804 | 2020-02-14 |
| 1578193892 | Heather Dawn Battles | Nurse Practitioner | 9785 Us Highway 278 W, Altoona, AL 35952-7771 | 2020-01-26 |
| 1548806540 | Hailey Hammond | Nurse Practitioner | 3101 26th Ave, Northport, AL 35476-5236 | 2019-11-25 |
| 1619511367 | Sarah Ashley Freeman | Nurse Practitioner | 363 Riverside Dr, Gadsden, AL 35903-2945 | 2019-11-05 |
| 1386206688 | Tasha Latiya Jones | Nurse Practitioner | 4950 Government Blvd Apt 75, Mobile, AL 36693-5011 | 2019-07-08 |
| 1891250262 | Corrie Graveman | Nurse Practitioner | 7070 Taylors Ferry Rd, Bessemer, AL 35023-5565 | 2019-02-09 |
| 1871057257 | Brittany Hendrix | Nurse Practitioner | 104 Camellia Ave Ste A, Greenville, AL 36037-1514 | 2019-01-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.