Healthcare Provider Details

I. General information

NPI: 1831711860
Provider Name (Legal Business Name): ASHLEY ELIZABETH MIJAL APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY E SCHMUHL APNP

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 N 3RD AVE
STURGEON BAY WI
54235-2401
US

IV. Provider business mailing address

PO BOX 22487
GREEN BAY WI
54305-2487
US

V. Phone/Fax

Practice location:
  • Phone: 920-743-0255
  • Fax: 920-743-6680
Mailing address:
  • Phone: 920-445-7210
  • Fax: 920-445-7289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10059-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: