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General NPI Number Information
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NPI Number | 1275883506
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Entity Type | Individual
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Provider Name | NICOLE ASHENBERNER LPN
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Gender | Female
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Dates
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Enumeration Date | 09/13/2012
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Last Update Date | 09/13/2012
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Provider Practice Location Address
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Address Line | 4400 SE RISLEY AVE
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City | MILWAUKIE
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State | OR
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Zip | 97267-2954
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Country | US
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Telephone | 971-998-4442
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Fax |
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Provider Business Mailing Address
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Address Line | 16544 SE WINDSWEPT WATERS DR
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City | DAMASCUS
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State | OR
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Zip | 97089-9100
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Country | US
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Telephone | 503-577-1836
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 201130133LPN
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License Number State | OR
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