Provider Demographics
NPI:1851029094
Name:UPSHAW, ASHLYN SHARP (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:SHARP
Last Name:UPSHAW
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4471 SCOTT HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:CULLEOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38451-3111
Mailing Address - Country:US
Mailing Address - Phone:931-215-3433
Mailing Address - Fax:
Practice Address - Street 1:4471 SCOTT HOLLOW RD
Practice Address - Street 2:
Practice Address - City:CULLEOKA
Practice Address - State:TN
Practice Address - Zip Code:38451-3111
Practice Address - Country:US
Practice Address - Phone:931-215-3433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-14
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN31942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily