Provider Demographics
NPI:1770154593
Name:HERMAN, ASHLEY DAWN (FNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DAWN
Last Name:HERMAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:DAWN
Other - Last Name:TRUJILLO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:206 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANON CITY
Mailing Address - State:CO
Mailing Address - Zip Code:81212-3730
Mailing Address - Country:US
Mailing Address - Phone:719-371-2911
Mailing Address - Fax:
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANON CITY
Practice Address - State:CO
Practice Address - Zip Code:81212-3730
Practice Address - Country:US
Practice Address - Phone:719-371-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-02
Last Update Date:2023-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2021040553363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily