Provider Demographics
NPI:1033527981
Name:ELLIMAN, ASHLEY (RN, NP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:ELLIMAN
Suffix:
Gender:F
Credentials:RN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 CATAMOUNT RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1210
Mailing Address - Country:US
Mailing Address - Phone:978-873-0047
Mailing Address - Fax:
Practice Address - Street 1:15 PARKMAN ST # 460
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-3117
Practice Address - Country:US
Practice Address - Phone:617-726-3373
Practice Address - Fax:617-643-5353
Is Sole Proprietor?:No
Enumeration Date:2014-07-23
Last Update Date:2016-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN283779163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse