Ashlyn Nicole Bazemore, LPN

Individual provider Active NPI Licensed Practical Nurse · Sylvania, GA

NPI 1093633653 · NPPES record last updated Jul 9, 2026

Key facts

NPI
1093633653
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
LPN093463 (GA)
Practice address
215 Mims Rd
Sylvania, GA 30467-1994
Phone
(912) 564-7426
NPI assigned
Jul 9, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN093463 GA Yes

Addresses

Primary practice location

215 Mims Rd
Sylvania, GA 30467-1994

Mailing address

215 Mims Rd
Sylvania, GA 30467-1994

Other providers in Sylvania, GA

All providers in Sylvania, GA · Licensed Practical Nurse in Georgia

Sources for this page

Verify at the official NPI Registry.