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NPI Code Detail

MEDICARE: ASHLEY RENEE NORTHERN MSN, APRN, FNP-C

MEDICARE: ASHLEY RENEE NORTHERN MSN, APRN, FNP-C
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
1363LF0000XFamily Nurse PractitionerAPRN.CNP.0030360OH

General Provider Information

NPI Number : 1134496334
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY RENEE NORTHERN MSN, APRN, FNP-C
Provider Business Mailing Address
First Line : 5981 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2211
Country : US
Telephone Number : 937-438-5954
Fax Number :
Provider Business Practice Location Address
First Line : 5981 FAR HILLS AVE
Second Line :
City : DAYTON
State : OH
Zip : 45429-2211
Country : US
Telephone Number : 937-438-5954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2011
Last Update Date : 05/01/2022

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