Healthcare Provider Details

I. General information

NPI: 1982175030
Provider Name (Legal Business Name): ASHLEY ANN KALIN APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2018
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2328 MEDICO LN
MELBOURNE FL
32940-7406
US

IV. Provider business mailing address

3628 IMPERATA DR
ROCKLEDGE FL
32955-6093
US

V. Phone/Fax

Practice location:
  • Phone: 321-956-1501
  • Fax: 321-956-1502
Mailing address:
  • Phone: 321-505-3999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11000359
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: