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
Fax: (414) 378-2279
Website:

Health care specialties

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417521501 NPPES
Wisconsin MEDICAID 100178967

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