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General NPI Number Information
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NPI Number | 1811768211
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Entity Type | Individual
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Provider Name | ASHLEY LASHAY MORMAN
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 1861 CORDOVA RD
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City | FORT LAUDERDALE
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State | FL
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Zip | 33316-2198
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Country | US
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Telephone | 754-778-8898
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Fax |
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Provider Business Mailing Address
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Address Line | 2001 LUDLAM RD APT 706
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City | MIAMI
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State | FL
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Zip | 33155-1988
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Country | US
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Telephone | 248-796-2173
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11030473
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License Number State | FL
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