Provider Demographics
NPI:1508463779
Name:WALTON, ASHLEY ZANDERS (APRN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ZANDERS
Last Name:WALTON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 FOXFIRE CT
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-7293
Mailing Address - Country:US
Mailing Address - Phone:352-286-8271
Mailing Address - Fax:
Practice Address - Street 1:75 FOXFIRE CT
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-7293
Practice Address - Country:US
Practice Address - Phone:352-286-8271
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-01
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009063208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice