MEDICARE: MRS. ASHLEY LYNN BOREING RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	431252	OH
2	163W00000X	Registered Nurse	1143466	KY

General Provider Information

NPI Number	:	1033669536
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY LYNN BOREING RN

Provider Business Mailing Address
First Line	:	3325 GLENMORE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6510
Country	:	US
Telephone Number	:	513-231-6630
Fax Number	:	513-471-4732

Provider Business Practice Location Address
First Line	:	3325 GLENMORE AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45211-6510
Country	:	US
Telephone Number	:	513-231-6630
Fax Number	:	513-471-4732

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2016
Last Update Date	:	10/07/2016

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