Provider Demographics
NPI:1437882867
Name:MONGEON, ASHLEY M (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:MONGEON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:12 PRINCETON ST APT 1
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02128-3488
Mailing Address - Country:US
Mailing Address - Phone:508-344-2283
Mailing Address - Fax:
Practice Address - Street 1:12 PRINCETON ST APT 1
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02128-3488
Practice Address - Country:US
Practice Address - Phone:508-344-2283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-04
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN2304511163W00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse