Boonnam, Ashley Lauren
Boonnam, Ashley Lauren is an individual health care provider with primary practice located at 8905 W Lincoln Ave Ste 501 , West Allis WI 53227-2470. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Boonnam, Ashley Lauren can be contacted via phone (414) 978-2229.Contact Information
Primary practice address
8905 W Lincoln Ave Ste 501
West Allis WI 53227-2470
Phone: (414) 978-2229
Fax: (414) 378-2279
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 10616-33 | Wisconsin |
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 10616 | Wisconsin |
Profile Details
NPI number | 1417521501 |
---|---|
LBN Legal business name | Boonnam, Ashley Lauren |
Credentials | FNP-BC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | May 13th, 2021 |
Last updated | Nov 24th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417521501 | NPPES |
Wisconsin | MEDICAID | 100178967 |
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