Provider Demographics
NPI:1801145040
Name:CORN, ASHLEY B (ARNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:CORN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:B
Other - Last Name:BELANGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5206 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33811-1645
Mailing Address - Country:US
Mailing Address - Phone:863-370-7557
Mailing Address - Fax:863-683-2579
Practice Address - Street 1:1920 LAKELAND HILLS BLVD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33805-2902
Practice Address - Country:US
Practice Address - Phone:863-683-4661
Practice Address - Fax:863-683-2579
Is Sole Proprietor?:No
Enumeration Date:2012-09-04
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9244690363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics