Provider Demographics
NPI:1902964380
Name:ASH, LAUREL JULIA (RN, DNP, CNP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:JULIA
Last Name:ASH
Suffix:
Gender:F
Credentials:RN, DNP, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S BOUNDARY AVE
Mailing Address - Street 2:
Mailing Address - City:PROCTOR
Mailing Address - State:MN
Mailing Address - Zip Code:55810-2306
Mailing Address - Country:US
Mailing Address - Phone:218-576-0200
Mailing Address - Fax:
Practice Address - Street 1:211 S BOUNDARY AVE
Practice Address - Street 2:
Practice Address - City:PROCTOR
Practice Address - State:MN
Practice Address - Zip Code:55810-2306
Practice Address - Country:US
Practice Address - Phone:218-576-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 97564-3363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN293043900Medicaid
MN500003796Medicare PIN
MNR04862Medicare UPIN
MN500003797Medicare PIN
MN500003795Medicare PIN