Provider Demographics
NPI:1386228716
Name:LEDET, ASHLEIGH ELIZABETH (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:ELIZABETH
Last Name:LEDET
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 WITZEL AVE STE A
Mailing Address - Street 2:
Mailing Address - City:OSHKOSH
Mailing Address - State:WI
Mailing Address - Zip Code:54904-8375
Mailing Address - Country:US
Mailing Address - Phone:920-233-1540
Mailing Address - Fax:414-386-4625
Practice Address - Street 1:2400 WITZEL AVE STE A
Practice Address - Street 2:
Practice Address - City:OSHKOSH
Practice Address - State:WI
Practice Address - Zip Code:54904-8375
Practice Address - Country:US
Practice Address - Phone:920-233-1540
Practice Address - Fax:414-386-4625
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5421363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant