Provider Demographics
NPI:1770210379
Name:WHITING, ASHTON TAYLOR (APRN)
Entity type:Individual
Prefix:MRS
First Name:ASHTON
Middle Name:TAYLOR
Last Name:WHITING
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 HIGHWAY 310
Mailing Address - Street 2:
Mailing Address - City:ENOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72047-8106
Mailing Address - Country:US
Mailing Address - Phone:501-628-8545
Mailing Address - Fax:
Practice Address - Street 1:625 UNITED DR STE 330
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-7828
Practice Address - Country:US
Practice Address - Phone:501-499-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR220480363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily