Provider Demographics
NPI:1841830494
Name:KORONKA, ASHLEE (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:KORONKA
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 1:11529 OSPREY POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-7682
Mailing Address - Country:US
Mailing Address - Phone:352-978-7003
Mailing Address - Fax:
Practice Address - Street 1:11529 OSPREY POINTE BLVD
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-7682
Practice Address - Country:US
Practice Address - Phone:352-978-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-12
Last Update Date:2020-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily