Provider Demographics
NPI:1083714968
Name:PULLEN, ASHLIE LYNN (NP)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:LYNN
Last Name:PULLEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 837
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45012-0837
Mailing Address - Country:US
Mailing Address - Phone:513-454-1460
Mailing Address - Fax:888-456-6653
Practice Address - Street 1:903 NW WASHINGTON BLVD STE A
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-6367
Practice Address - Country:US
Practice Address - Phone:513-454-1111
Practice Address - Fax:513-737-1592
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN184471 NP363LW0102X
OH0034594363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q76365Medicare UPIN