Provider Demographics
NPI:1336524354
Name:BULEN, ASHLEY N (AUD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:BULEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:N
Other - Last Name:LINDBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:7718 SIX FORKS RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-5071
Mailing Address - Country:US
Mailing Address - Phone:919-670-3777
Mailing Address - Fax:
Practice Address - Street 1:7718 SIX FORKS RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27615
Practice Address - Country:US
Practice Address - Phone:919-670-3777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-21
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1772231H00000X
NC12149231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ019621Medicaid
TN103I647546Medicare PIN