Provider Demographics
NPI:1720391220
Name:MCCAULEY, ASHLEY MAE (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MAE
Last Name:MCCAULEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MAE
Other - Last Name:FRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:712 S CASCADE ST
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2913
Mailing Address - Country:US
Mailing Address - Phone:218-736-8000
Mailing Address - Fax:218-736-8719
Practice Address - Street 1:712 S CASCADE ST
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2913
Practice Address - Country:US
Practice Address - Phone:218-739-2221
Practice Address - Fax:218-736-8719
Is Sole Proprietor?:No
Enumeration Date:2010-07-26
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-182692-4363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily