Individual
ASHLEY FATHEREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11850 BLACKFOOT ST NW STE 100, COON RAPIDS, MN 55433-2774
(763) 712-2100
(763) 712-2190
Mailing address
11850 BLACKFOOT ST NW STE 100, COON RAPIDS, MN 55433-2774
(763) 712-2100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024186462
VA
363L00000X
Nurse Practitioner
Primary
10482
MN
363LA2200X
Adult Health Nurse Practitioner
RN1051347
DC
Other
Enumeration date
06/21/2021
Last updated
08/09/2023
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