Provider Demographics
NPI:1013632314
Name:FELICIANO, ASHLEY ANN (RN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ANN
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:ANN
Other - Last Name:MILLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:2636 SOMERVILLE LOOP APT 1607
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33991-4111
Mailing Address - Country:US
Mailing Address - Phone:239-896-8321
Mailing Address - Fax:
Practice Address - Street 1:636 DEL PRADO BLVD
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33990-2695
Practice Address - Country:US
Practice Address - Phone:239-424-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9464373163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse