Provider Demographics
NPI:1356673230
Name:KLEKAMP, ASHLEY WELCH (APN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WELCH
Last Name:KLEKAMP
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9267 CHEVOIT DR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6137
Mailing Address - Country:US
Mailing Address - Phone:615-969-4301
Mailing Address - Fax:
Practice Address - Street 1:9267 CHEVOIT DR
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-6137
Practice Address - Country:US
Practice Address - Phone:615-969-4301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN14738363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I501849Medicare PIN