Provider Demographics
NPI:1508418740
Name:DEATON, ASHLEY BROOKE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BROOKE
Last Name:DEATON
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:BROOKE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-C
Mailing Address - Street 1:801 W BAY DR STE 605
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33770-3268
Mailing Address - Country:US
Mailing Address - Phone:252-671-1108
Mailing Address - Fax:
Practice Address - Street 1:1501 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-3717
Practice Address - Country:US
Practice Address - Phone:252-671-1108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily