Provider Demographics
NPI:1033660261
Name:HEAD, ASHLEY DANIELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:HEAD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 GLYNCO PKWY
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-6845
Mailing Address - Country:US
Mailing Address - Phone:912-265-4735
Mailing Address - Fax:912-265-6100
Practice Address - Street 1:1692 GLYNCO PKWY
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31525-6845
Practice Address - Country:US
Practice Address - Phone:912-265-4735
Practice Address - Fax:912-265-6100
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN208975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily