Provider Demographics
NPI:1760266282
Name:ASHMEADE, STACYANN KARLEEN
Entity Type:Individual
Prefix:
First Name:STACYANN
Middle Name:KARLEEN
Last Name:ASHMEADE
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 1:6848 LIMPKIN DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-6079
Mailing Address - Country:US
Mailing Address - Phone:407-722-4835
Mailing Address - Fax:
Practice Address - Street 1:6848 LIMPKIN DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-6079
Practice Address - Country:US
Practice Address - Phone:407-722-4835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2276283747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant