Provider Demographics
NPI:1447842356
Name:MERLINO, ASHLEE CAMILLE (APRN)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:CAMILLE
Last Name:MERLINO
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6720 S FLORIDA AVE APT 4101
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3342
Mailing Address - Country:US
Mailing Address - Phone:813-240-7667
Mailing Address - Fax:
Practice Address - Street 1:6720 S FLORIDA AVE APT 4101
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3342
Practice Address - Country:US
Practice Address - Phone:813-240-7667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-11
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1011267363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty