Provider Demographics
NPI:1992444616
Name:BELLANT, ASHLEY (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:BELLANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:CHRISTINE
Other - Last Name:BLALOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15950 SINGLETARY RD
Mailing Address - Street 2:
Mailing Address - City:MYAKKA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34251-9318
Mailing Address - Country:US
Mailing Address - Phone:727-804-3172
Mailing Address - Fax:
Practice Address - Street 1:1951 S MCCALL RD STE 700
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-4937
Practice Address - Country:US
Practice Address - Phone:941-205-0520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11019481363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner