Provider Demographics
NPI:1669902276
Name:DORNAN, ASHLINN (MS, RD)
Entity type:Individual
Prefix:
First Name:ASHLINN
Middle Name:
Last Name:DORNAN
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39TH MEDICAL GROUP, U.S. AIR FORCE, INCIRLIK AIR BASE
Mailing Address - Street 2:39 MDG/SGH UNIT 7095 BOX 185
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09824-5185
Mailing Address - Country:US
Mailing Address - Phone:314-676-8256
Mailing Address - Fax:
Practice Address - Street 1:39TH MEDICAL GROUP U.S. AIR FORCE INCIRLIK AIR BASE
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09824-5185
Practice Address - Country:US
Practice Address - Phone:314-676-8256
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86064832133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered