Provider Demographics
NPI:1376848648
Name:AUSTIN, ASHLEY DAWN (LPN)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:DAWN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 N BELLS ST
Mailing Address - Street 2:
Mailing Address - City:ALAMO
Mailing Address - State:TN
Mailing Address - Zip Code:38001-1755
Mailing Address - Country:US
Mailing Address - Phone:731-696-2505
Mailing Address - Fax:731-696-4370
Practice Address - Street 1:209 N BELLS ST
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TN
Practice Address - Zip Code:38001-1755
Practice Address - Country:US
Practice Address - Phone:731-696-2505
Practice Address - Fax:731-696-4370
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2011-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN75668164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse