Provider Demographics
NPI:1326444589
Name:PIPPIN, ASHLEY M (RN, FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:PIPPIN
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:BERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP
Mailing Address - Street 1:210 WESTSIDE DRIVE
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303
Mailing Address - Country:US
Mailing Address - Phone:334-793-5074
Mailing Address - Fax:
Practice Address - Street 1:210 WESTSIDE DRIVE
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303
Practice Address - Country:US
Practice Address - Phone:334-793-5074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-125182363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily