Provider Demographics
NPI:1104089069
Name:KROHN, ASHLEY D (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:KROHN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N 37TH ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-3275
Mailing Address - Country:US
Mailing Address - Phone:402-370-4100
Mailing Address - Fax:402-370-4101
Practice Address - Street 1:305 N 37TH ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3275
Practice Address - Country:US
Practice Address - Phone:402-370-4100
Practice Address - Fax:402-370-4101
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1393363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10026109600Medicaid
NEXXXXX697216Medicaid
NENA1959021OtherMEDICARE
NE10025411700Medicaid
KS200566370AMedicaid
NE47039317600Medicaid
NE47039317612Medicaid
NE10025988200Medicaid
NEP00675985OtherRAILROAD MEDICARE
KS200566370BMedicaid
KS200566370BMedicaid
NEP00675985OtherRAILROAD MEDICARE
NENA1903004Medicare PIN