Healthcare Provider Details

I. General information

NPI: 1376372615
Provider Name (Legal Business Name): ASHLEY WHEALON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY WEDOFF APNP

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

IV. Provider business mailing address

3200 PLEASANT VALLEY RD
WEST BEND WI
53095-9274
US

V. Phone/Fax

Practice location:
  • Phone: 262-836-5528
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number245798-30
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number15648-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: