Provider Demographics
NPI:1215386065
Name:MOYER, ASHLEY RENEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:RENEE
Last Name:MOYER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:RENEE
Other - Last Name:LINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1102 NW LOWES AVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-8093
Mailing Address - Country:US
Mailing Address - Phone:479-553-2470
Mailing Address - Fax:
Practice Address - Street 1:1102 NW LOWES AVE
Practice Address - Street 2:SUITE 4
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-8093
Practice Address - Country:US
Practice Address - Phone:479-553-2470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-11
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004767363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health