Provider Demographics
NPI:1669806493
Name:MUNN, ASHLEY ROBINSON (APRN)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ROBINSON
Last Name:MUNN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 CLEMSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7925
Mailing Address - Country:US
Mailing Address - Phone:803-438-3800
Mailing Address - Fax:803-438-3898
Practice Address - Street 1:460 CLEMSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7925
Practice Address - Country:US
Practice Address - Phone:803-438-3800
Practice Address - Fax:803-438-3898
Is Sole Proprietor?:No
Enumeration Date:2013-08-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN 18460363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAPN 18460OtherAPRN LICENSE
SCAPN 18460OtherAPRN LICENSE