MEDICARE: ASHLEY LYN WHEELER MS, RD, LD-N

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	133V00000X	Registered Dietitian	ND 6933	FL

General Provider Information

NPI Number	:	1265845572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LYN WHEELER MS, RD, LD-N

Provider Business Mailing Address
First Line	:	851 5TH AVE N
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34102-5582
Country	:	US
Telephone Number	:	239-659-7700
Fax Number	:

Provider Business Practice Location Address
First Line	:	851 5TH AVE N
Second Line	:	SUITE 201
City	:	NAPLES
State	:	FL
Zip	:	34102-5582
Country	:	US
Telephone Number	:	239-659-7700
Fax Number	:

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

Provider Enumeration Date	:	06/04/2014
Last Update Date	:	06/04/2014

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