Provider Demographics
NPI:1467173641
Name:MINTON, ASHLEY S (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:MINTON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-2234
Mailing Address - Country:US
Mailing Address - Phone:423-573-1502
Mailing Address - Fax:
Practice Address - Street 1:2045 VALLEY VIEW DR.
Practice Address - Street 2:HERITAGE HALL
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3319
Practice Address - Country:US
Practice Address - Phone:423-573-1502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024184614363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily