Provider Demographics
NPI:1124497128
Name:KRULL, ASHLEY K (CPNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:K
Last Name:KRULL
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:532 POINTE ESSEX CT
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-3644
Mailing Address - Country:US
Mailing Address - Phone:573-330-5905
Mailing Address - Fax:
Practice Address - Street 1:3009 N BALLAS RD STE 131A
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2341
Practice Address - Country:US
Practice Address - Phone:314-994-0209
Practice Address - Fax:314-994-9130
Is Sole Proprietor?:No
Enumeration Date:2015-09-20
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014042049363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics