Healthcare Provider Details

I. General information

NPI: 1275256778
Provider Name (Legal Business Name): ASHLEY GILLSTRAP APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 01/26/2023
Certification Date: 01/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 S LIMESTONE
LEXINGTON KY
40506-0007
US

IV. Provider business mailing address

1000 S LIMESTONE
LEXINGTON KY
40506-0007
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-9057
  • Fax: 859-323-9502
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number3018304
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number3018304
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: