Healthcare Provider Details

I. General information

NPI: 1407588957
Provider Name (Legal Business Name): ASHLEY NICOLE HULL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2022
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

897 IRONWOOD DR
MINDEN NV
89423-5198
US

IV. Provider business mailing address

PO BOX 3682
STATELINE NV
89449-3682
US

V. Phone/Fax

Practice location:
  • Phone: 775-782-1610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: