Provider Demographics
NPI:1578948899
Name:ANDRUS, ASHLEY J (APNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:J
Last Name:ANDRUS
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2223 LIME KILN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54311-6238
Mailing Address - Country:US
Mailing Address - Phone:920-430-8113
Mailing Address - Fax:920-430-8122
Practice Address - Street 1:2223 LIME KILN RD STE 1
Practice Address - Street 2:
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54311-6238
Practice Address - Country:US
Practice Address - Phone:920-430-8113
Practice Address - Fax:920-430-8122
Is Sole Proprietor?:No
Enumeration Date:2015-07-28
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6509-33363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care