Provider Demographics
NPI:1255002531
Name:TRAWICK, ASHLEY MONIQUE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MONIQUE
Last Name:TRAWICK
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 3RD ST
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3404
Mailing Address - Country:US
Mailing Address - Phone:478-751-2900
Mailing Address - Fax:
Practice Address - Street 1:124 3RD ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3404
Practice Address - Country:US
Practice Address - Phone:478-751-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-25
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN235976363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily