Healthcare Provider Details

I. General information

NPI: 1194665307
Provider Name (Legal Business Name): ASHLEY DEML RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 STATE ROAD 16
LA CROSSE WI
54601-1809
US

IV. Provider business mailing address

4000 STATE ROAD 16
LA CROSSE WI
54601-1809
US

V. Phone/Fax

Practice location:
  • Phone: 608-784-3886
  • Fax:
Mailing address:
  • Phone: 608-784-3886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number174349-30
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: