Provider Demographics
NPI:1952885634
Name:LUMPKIN, ASHLEY KAYE (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KAYE
Last Name:LUMPKIN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:KAYE
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:495 DALLAS WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKY FACE
Mailing Address - State:GA
Mailing Address - Zip Code:30740-3014
Mailing Address - Country:US
Mailing Address - Phone:706-934-4999
Mailing Address - Fax:
Practice Address - Street 1:2709 AIRPORT RD STE 101
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-0252
Practice Address - Country:US
Practice Address - Phone:706-275-4444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN204051363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1033263769OtherGROUP NPI