Provider Demographics
NPI:1861182933
Name:JUNTUNEN, ASHLEY NICOLE (DNP, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:NICOLE
Last Name:JUNTUNEN
Suffix:
Gender:F
Credentials:DNP, APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 SHERWOOD DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LAKE BLUFF
Mailing Address - State:IL
Mailing Address - Zip Code:60044-2224
Mailing Address - Country:US
Mailing Address - Phone:847-295-1220
Mailing Address - Fax:847-295-1255
Practice Address - Street 1:917 SHERWOOD DR STE 100
Practice Address - Street 2:
Practice Address - City:LAKE BLUFF
Practice Address - State:IL
Practice Address - Zip Code:60044-2224
Practice Address - Country:US
Practice Address - Phone:847-295-1220
Practice Address - Fax:847-295-1255
Is Sole Proprietor?:No
Enumeration Date:2023-05-11
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209027375363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics