Provider Demographics
NPI:1104267160
Name:HUNTER, ASHLEY S (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:S
Last Name:HUNTER
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 1:4403 CASTLEBAR WAY
Mailing Address - Street 2:
Mailing Address - City:VALRICO
Mailing Address - State:FL
Mailing Address - Zip Code:33596-7296
Mailing Address - Country:US
Mailing Address - Phone:631-902-9433
Mailing Address - Fax:
Practice Address - Street 1:2370 WALDEN WOODS DR STE A
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7027
Practice Address - Country:US
Practice Address - Phone:813-659-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-07
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673153-1163W00000X
FLAPRN11001552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL105131900Medicaid