Provider Demographics
NPI:1912869306
Name:DEZEEUW, ASHTON ROSE
Entity type:Individual
Prefix:
First Name:ASHTON
Middle Name:ROSE
Last Name:DEZEEUW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5030 10TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-4042
Mailing Address - Country:US
Mailing Address - Phone:320-226-9358
Mailing Address - Fax:
Practice Address - Street 1:2050 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1738
Practice Address - Country:US
Practice Address - Phone:859-251-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-24
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2523410163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse