Provider Demographics
NPI:1932973468
Name:FORT, ASHLEE N (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEE
Middle Name:N
Last Name:FORT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ASHLEE
Other - Middle Name:N
Other - Last Name:MCCARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7930 W WILMONT TRL
Mailing Address - Street 2:
Mailing Address - City:NEW PALESTINE
Mailing Address - State:IN
Mailing Address - Zip Code:46163-0003
Mailing Address - Country:US
Mailing Address - Phone:317-439-5346
Mailing Address - Fax:
Practice Address - Street 1:1030 W MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5201
Practice Address - Country:US
Practice Address - Phone:317-944-0920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-15
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71014748A363LF0000X
IN28190771A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse