Provider Demographics
NPI:1891117354
Name:LUNDSTROM, ASHLEY L (APRN-BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:LUNDSTROM
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:L
Other - Last Name:WATSEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1500 S. 48TH STREET
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-1200
Mailing Address - Country:US
Mailing Address - Phone:402-483-8600
Mailing Address - Fax:402-483-8693
Practice Address - Street 1:1500 S. 48TH STREET
Practice Address - Street 2:SUITE 800
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1200
Practice Address - Country:US
Practice Address - Phone:402-483-8600
Practice Address - Fax:402-483-8693
Is Sole Proprietor?:No
Enumeration Date:2014-01-16
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111546363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care