Provider Demographics
NPI:1477169837
Name:TAYLOR, ASHLEY MARLENA (APNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARLENA
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 S SUNNY SLOPE RD
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-7060
Mailing Address - Country:US
Mailing Address - Phone:262-798-8750
Mailing Address - Fax:
Practice Address - Street 1:1350 S SUNNY SLOPE RD
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-7060
Practice Address - Country:US
Practice Address - Phone:262-798-8750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-21
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI102533-33363LF0000X
WI10253-33363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily