Provider Demographics
NPI:1902400187
Name:REHMANN, ASHLEY (APRN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:REHMANN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5655 S ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32809-4289
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5655 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:FL
Practice Address - Zip Code:32809-4289
Practice Address - Country:US
Practice Address - Phone:866-742-6655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9410635163WG0000X
FL11011100363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLWILYIOtherBLUE CROSS BLUE SHIELD
FL110443600Medicaid