Provider Demographics
NPI:1013521285
Name:BONNELL, ASHLEY RENEE (FN-P)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:RENEE
Last Name:BONNELL
Suffix:
Gender:F
Credentials:FN-P
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:RENEE
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2060 LAKESIDE CENTRE WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-6591
Mailing Address - Country:US
Mailing Address - Phone:865-218-6222
Mailing Address - Fax:865-218-6220
Practice Address - Street 1:2060 LAKESIDE CENTRE WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-6591
Practice Address - Country:US
Practice Address - Phone:865-218-6222
Practice Address - Fax:833-671-1059
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN28227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN777937AMedicaid