Provider Demographics
NPI:1568226652
Name:STORER, ASHLEY LYN (APRN, DNP/FNP-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYN
Last Name:STORER
Suffix:
Gender:F
Credentials:APRN, DNP/FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1371 E MURPHYS LN
Mailing Address - Street 2:
Mailing Address - City:MILLCREEK
Mailing Address - State:UT
Mailing Address - Zip Code:84106-2931
Mailing Address - Country:US
Mailing Address - Phone:435-770-5795
Mailing Address - Fax:
Practice Address - Street 1:10011 S CENTENNIAL PKWY STE 350
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4137
Practice Address - Country:US
Practice Address - Phone:801-566-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6551115-4405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine