Individual
ASHLEY LICHTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804-4140
(260) 203-9600
(260) 203-9602
Mailing address
PO BOX 11766, FORT WAYNE, IN 46860-1766
(260) 203-9600
(260) 407-8006
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28191558A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201281000
—
IN
Enumeration date
01/13/2015
Last updated
04/26/2016
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