Provider Demographics
NPI:1275972713
Name:ASHLINE, JENNIFER L (PA)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:L
Last Name:ASHLINE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:354 MOUNTAIN VIEW DR., #103
Mailing Address - Street 2:UVM MEDICAL CENTER, SURGERY/PLASTICS
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401
Mailing Address - Country:US
Mailing Address - Phone:802-847-3340
Mailing Address - Fax:802-847-7083
Practice Address - Street 1:354 MOUNTAIN VIEW DR., #103
Practice Address - Street 2:UVM MEDICAL CENTER, SURGERY/PLASTICS
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401
Practice Address - Country:US
Practice Address - Phone:802-847-3340
Practice Address - Fax:802-847-7083
Is Sole Proprietor?:No
Enumeration Date:2013-06-18
Last Update Date:2016-08-24
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Provider Licenses
StateLicense IDTaxonomies
363A00000X
VT055.0031303363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant