Provider Demographics
NPI:1821560863
Name:FAITH, ASHLEY MARY (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MARY
Last Name:FAITH
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MARY
Other - Last Name:MANDEVILLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5132 CONTOURA DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-1808
Mailing Address - Country:US
Mailing Address - Phone:407-314-6688
Mailing Address - Fax:
Practice Address - Street 1:1222 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-1215
Practice Address - Country:US
Practice Address - Phone:407-650-1300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9311716363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care