Provider Demographics
NPI:1972317592
Name:MUNTIN, ASHLYN NOEL (FNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLYN
Middle Name:NOEL
Last Name:MUNTIN
Suffix:
Gender:
Credentials:FNP
Other - Prefix:MISS
Other - First Name:ASHLYN
Other - Middle Name:NOEL
Other - Last Name:COCKRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10220 SHAWNEE TRL
Mailing Address - Street 2:
Mailing Address - City:GAYLORD
Mailing Address - State:MI
Mailing Address - Zip Code:49735-8848
Mailing Address - Country:US
Mailing Address - Phone:305-240-9970
Mailing Address - Fax:
Practice Address - Street 1:829 N CENTER AVE STE 140
Practice Address - Street 2:
Practice Address - City:GAYLORD
Practice Address - State:MI
Practice Address - Zip Code:49735-1598
Practice Address - Country:US
Practice Address - Phone:989-731-7870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704353097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily