Provider Demographics
NPI:1447885942
Name:DICKENS, ASHLEE (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEE
Middle Name:
Last Name:DICKENS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2215 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4403
Mailing Address - Country:US
Mailing Address - Phone:573-271-5317
Mailing Address - Fax:
Practice Address - Street 1:1349 US HIGHWAY 61
Practice Address - Street 2:
Practice Address - City:FESTUS
Practice Address - State:MO
Practice Address - Zip Code:63028-4107
Practice Address - Country:US
Practice Address - Phone:636-937-3500
Practice Address - Fax:573-335-6724
Is Sole Proprietor?:No
Enumeration Date:2020-03-05
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020007740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily