Provider Demographics
NPI:1164208021
Name:MERRITT, ASHLEY BROOKE (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:MERRITT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 171
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72702-0171
Mailing Address - Country:US
Mailing Address - Phone:479-439-3638
Mailing Address - Fax:844-694-0131
Practice Address - Street 1:217 E DICKSON ST STE 101
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72701-4629
Practice Address - Country:US
Practice Address - Phone:479-439-3638
Practice Address - Fax:844-694-0131
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-06
Last Update Date:2025-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225485363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health