Healthcare Provider Details

I. General information

NPI: 1649139510
Provider Name (Legal Business Name): ASHLEY AMMERMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/16/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

797 LEESBURG PIKE
GEORGETOWN KY
40324-9766
US

IV. Provider business mailing address

480 BULLION BLVD STE B
WINCHESTER KY
40391-2933
US

V. Phone/Fax

Practice location:
  • Phone: 859-948-1358
  • Fax:
Mailing address:
  • Phone: 859-385-4222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4056172
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: