Provider Demographics
NPI:1629717244
Name:WALTERS, ASHLEY MARIE LEBLANC (DO)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MARIE LEBLANC
Last Name:WALTERS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2450 RIVERSIDE AVE S AO 102
Mailing Address - Street 2:DELIVERY CODE 8951
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454
Mailing Address - Country:US
Mailing Address - Phone:612-624-8788
Mailing Address - Fax:
Practice Address - Street 1:2450 RIVERSIDE AVE S AO-102
Practice Address - Street 2:DELIVERY CODE 8951
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454
Practice Address - Country:US
Practice Address - Phone:612-624-8788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9281208000000X
MN798212080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics