Basic Information
Provider Information
NPI: 1265058226
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: UNEY
FirstName: ASHLEY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1505 53RD AVE E
Address2:  
City: BRADENTON
State: FL
PostalCode: 342034249
CountryCode: US
TelephoneNumber: 9413577950
FaxNumber: 9418401003
Practice Location
Address1: 1505 53RD AVE E
Address2:  
City: BRADENTON
State: FL
PostalCode: 342034249
CountryCode: US
TelephoneNumber: 9413577950
FaxNumber: 9418401003
Other Information
ProviderEnumerationDate: 06/24/2020
LastUpdateDate: 12/29/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/29/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XAPRN11009828FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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