Provider Demographics
NPI:1053676536
Name:ASH, YVETTE MONIQUE (FNP)
Entity Type:Individual
Prefix:
First Name:YVETTE
Middle Name:MONIQUE
Last Name:ASH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 BENTEEN PARK DR SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30315-4441
Mailing Address - Country:US
Mailing Address - Phone:407-221-6830
Mailing Address - Fax:
Practice Address - Street 1:6053 JONESBORO RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-1106
Practice Address - Country:US
Practice Address - Phone:707-824-4343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-10
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9234608363LF0000X
NY337130363LF0000X
GARN276955363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily