Provider Demographics
NPI:1689390205
Name:FUEGEN, ASHLEE
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:FUEGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:GOOSE LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:52750-0174
Mailing Address - Country:US
Mailing Address - Phone:563-528-4313
Mailing Address - Fax:
Practice Address - Street 1:10 SCHOOL LN
Practice Address - Street 2:
Practice Address - City:GOOSE LAKE
Practice Address - State:IA
Practice Address - Zip Code:52750-7703
Practice Address - Country:US
Practice Address - Phone:563-528-4313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-14
Last Update Date:2022-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide