Provider Demographics
NPI:1710768734
Name:GORMLEY, ASHLEY (PRN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:GORMLEY
Suffix:
Gender:F
Credentials:PRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6900 L ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-2478
Mailing Address - Country:US
Mailing Address - Phone:402-441-5600
Mailing Address - Fax:
Practice Address - Street 1:6900 L ST STE 1
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-2478
Practice Address - Country:US
Practice Address - Phone:402-441-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE115001363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner