Healthcare Provider Details

I. General information

NPI: 1558040741
Provider Name (Legal Business Name): ASHLEY ELIZABETH MULLINS RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2023
Last Update Date: 07/14/2023
Certification Date: 07/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W MAIN ST
FREEHOLD NJ
07728-2549
US

IV. Provider business mailing address

630 LITTLE SILVER POINT RD
LITTLE SILVER NJ
07739-1737
US

V. Phone/Fax

Practice location:
  • Phone: 732-294-2921
  • Fax:
Mailing address:
  • Phone: 908-902-9142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number20NR20833400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: