Provider Demographics
NPI:1619523131
Name:JERVE, ASHLEY M (CNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:JERVE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:LENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:824 N 11TH ST
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-1629
Mailing Address - Country:US
Mailing Address - Phone:320-269-8877
Mailing Address - Fax:320-269-8186
Practice Address - Street 1:824 N 11TH ST
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-1629
Practice Address - Country:US
Practice Address - Phone:320-269-8877
Practice Address - Fax:320-269-8186
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6725363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily