Provider Demographics
NPI:1699288845
Name:GROUT, ASHLEY LYNN (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:GROUT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10151 ENTERPRISE CTR STE 106
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3760
Mailing Address - Country:US
Mailing Address - Phone:561-734-7400
Mailing Address - Fax:561-734-7448
Practice Address - Street 1:10151 ENTERPRISE CTR STE 106
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437
Practice Address - Country:US
Practice Address - Phone:561-734-7400
Practice Address - Fax:561-734-7448
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9361181363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner