Provider Demographics
NPI:1255676896
Name:PONTENBERG, ASHLEY ANN (APRN, NP-C)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:ANN
Last Name:PONTENBERG
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2306 ASHLEY OAKS CIR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-6435
Mailing Address - Country:US
Mailing Address - Phone:813-991-0088
Mailing Address - Fax:
Practice Address - Street 1:917 N PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-2456
Practice Address - Country:US
Practice Address - Phone:813-361-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-09
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9237068363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health