Provider Demographics
NPI:1457925471
Name:O'SHIELDS, ASHLEY (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:O'SHIELDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:3920 ST FRANCIS WAY STE 100
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47905-4917
Practice Address - Country:US
Practice Address - Phone:765-428-5990
Practice Address - Fax:765-428-5896
Is Sole Proprietor?:No
Enumeration Date:2021-05-14
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71011195A363LF0000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology