Provider Demographics
NPI:1174187884
Name:RODRIAN, ASHLEY A (APNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:A
Last Name:RODRIAN
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:A
Other - Last Name:KOCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 NEENAH CTR
Mailing Address - Street 2:
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-3070
Mailing Address - Country:US
Mailing Address - Phone:920-729-2933
Mailing Address - Fax:920-727-4511
Practice Address - Street 1:200 THEDA CLARK MEDICAL PLZ
Practice Address - Street 2:
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2721
Practice Address - Country:US
Practice Address - Phone:920-729-2933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9401363LF0000X
WI226556163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse