Provider Demographics
NPI:1255997227
Name:TOMPKINS, ASHLEY (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:TOMPKINS
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 1:464 GLENDALE LN
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32065-5606
Mailing Address - Country:US
Mailing Address - Phone:904-327-9949
Mailing Address - Fax:
Practice Address - Street 1:4866 BIG ISLAND DR UNIT 5
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32246-5301
Practice Address - Country:US
Practice Address - Phone:904-652-0652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11001880363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner