Provider Demographics
NPI:1871976845
Name:TUTTLE, ASHLEY LEEANN (MSN, RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LEEANN
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:MSN, RN, CPNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LEEANN
Other - Last Name:POPKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, RN, CPNP
Mailing Address - Street 1:403 FAIRVIEW ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-2311
Mailing Address - Country:US
Mailing Address - Phone:910-590-0619
Mailing Address - Fax:
Practice Address - Street 1:403 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-2311
Practice Address - Country:US
Practice Address - Phone:910-590-0619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC205955363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics