Provider Demographics
NPI:1215409065
Name:EDMONDSON, ASHLEY DANIELLE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:DANIELLE
Last Name:EDMONDSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:DANIELLE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:318 RICHLAND WEST CIR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7919
Mailing Address - Country:US
Mailing Address - Phone:254-776-8008
Mailing Address - Fax:
Practice Address - Street 1:318 RICHLAND WEST CIR STE A
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7919
Practice Address - Country:US
Practice Address - Phone:254-776-8008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP139992363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily