Provider Demographics
NPI:1265845572
Name:WHEELER, ASHLEY LYN (MS, RD, LD-N)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:MS, RD, LD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 5TH AVE N
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5582
Mailing Address - Country:US
Mailing Address - Phone:239-659-7700
Mailing Address - Fax:
Practice Address - Street 1:851 5TH AVE N
Practice Address - Street 2:SUITE 201
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5582
Practice Address - Country:US
Practice Address - Phone:239-659-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLND 6933133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered