Provider Demographics
NPI:1508126509
Name:CARAVELLI, ASHLEY (DO)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:
Last Name:CARAVELLI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E MORRISSY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:WI
Mailing Address - Zip Code:53121-4395
Mailing Address - Country:US
Mailing Address - Phone:262-723-3100
Mailing Address - Fax:262-723-3438
Practice Address - Street 1:201 E MORRISSEY DR
Practice Address - Street 2:
Practice Address - City:ELKHORN
Practice Address - State:WI
Practice Address - Zip Code:53121-4395
Practice Address - Country:US
Practice Address - Phone:262-723-3100
Practice Address - Fax:262-723-3438
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI63659-21207Q00000X
IL125-061168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine