Provider Demographics
NPI:1386358323
Name:CERNELL, ASHLEY PATRICIA (APRN-PC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:PATRICIA
Last Name:CERNELL
Suffix:
Gender:F
Credentials:APRN-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 RUSTIC LOOP
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32771-7581
Mailing Address - Country:US
Mailing Address - Phone:407-792-9816
Mailing Address - Fax:
Practice Address - Street 1:2104 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2906
Practice Address - Country:US
Practice Address - Phone:407-898-2767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11023872363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner