Provider Demographics
NPI:1497122444
Name:ASHMORE, DUSTIN LYNN (APRN)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:LYNN
Last Name:ASHMORE
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2711 S ROUSE ST
Mailing Address - Street 2:STE F
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-6620
Mailing Address - Country:US
Mailing Address - Phone:620-232-9000
Mailing Address - Fax:
Practice Address - Street 1:2711 S ROUSE ST
Practice Address - Street 2:STE F
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-6620
Practice Address - Country:US
Practice Address - Phone:620-232-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76905-071363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily