Provider Demographics
NPI:1265151591
Name:ASH, DAWANNA DENISE (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:DAWANNA
Middle Name:DENISE
Last Name:ASH
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:DAWANNA
Other - Middle Name:DENISE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:17133 YELLOW PINE ST
Mailing Address - Street 2:
Mailing Address - City:WIMAUMA
Mailing Address - State:FL
Mailing Address - Zip Code:33598-2514
Mailing Address - Country:US
Mailing Address - Phone:941-587-9766
Mailing Address - Fax:
Practice Address - Street 1:219 PALERMO PL
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34285-2821
Practice Address - Country:US
Practice Address - Phone:941-244-9524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11020428363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily