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NPI Code Detail

MEDICARE: MRS. ASHLEY PELTON

MEDICARE:  MRS. ASHLEY  PELTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1013290998
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY PELTON
Provider Business Mailing Address
First Line : 5610 CRAWFORDSVILLE RD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46224-3714
Country : US
Telephone Number : 317-241-4673
Fax Number : 317-241-0201
Provider Business Practice Location Address
First Line : 5610 CRAWFORDSVILLE RD
Second Line : SUITE 200
City : INDIANAPOLIS
State : IN
Zip : 46224-3714
Country : US
Telephone Number : 317-241-4673
Fax Number : 317-241-0201
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2011
Last Update Date : 11/15/2016

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Directions to “ MRS. ASHLEY PELTON ” Practice Location

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