Individual
KIRK D ASHBURN II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.R.N.P.
Contact information
Practice address
1212 PROFESSIONAL BLVD STE B, EVANSVILLE, IN 47714-8002
(812) 401-9030
(812) 401-9033
Mailing address
1212 PROFESSIONAL BLVD STE B, EVANSVILLE, IN 47714-8002
(812) 401-9030
(812) 401-9033
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
71001760A
IN
363L00000X
Nurse Practitioner
Primary
71001760A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387509
ANTHEM PIN
IN
05
—
200207810
—
IN
01
—
P00333134
RAILROAD MEDICARE
IN
Enumeration date
07/05/2005
Last updated
07/21/2022
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