Provider Demographics
NPI:1508477209
Name:WILLIAMSON, ASHLEIGH RENEE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:RENEE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:ASHLEIGH
Other - Middle Name:RENEE
Other - Last Name:BULLOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1737
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:KY
Mailing Address - Zip Code:42633-4737
Mailing Address - Country:US
Mailing Address - Phone:606-753-0293
Mailing Address - Fax:606-753-0291
Practice Address - Street 1:268 ROLLING HILLS BLVD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-9004
Practice Address - Country:US
Practice Address - Phone:606-753-0293
Practice Address - Fax:606-753-0291
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3014842363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100687200Medicaid