Provider Demographics
NPI:1265942106
Name:EISENBROWN, ASHLYN MADDEN (LAC)
Entity type:Individual
Prefix:
First Name:ASHLYN
Middle Name:MADDEN
Last Name:EISENBROWN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1501 JACKSON ST APT 407
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-3156
Mailing Address - Country:US
Mailing Address - Phone:512-779-5657
Mailing Address - Fax:
Practice Address - Street 1:1219 LEAVENWORTH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102
Practice Address - Country:US
Practice Address - Phone:402-884-1300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-05
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE61171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist