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NPI Code Detail

MEDICARE: ASHLEY NICOLE EVICK CRNA

MEDICARE: ASHLEY NICOLE EVICK CRNA
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
1163W00000XRegistered NurseRN604809PA
2367500000XCertified Registered Nurse AnesthetistRN604809PA

General Provider Information

NPI Number : 1225432594
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY NICOLE EVICK CRNA
Provider Business Mailing Address
First Line : 2363 W GATESBURG RD
Second Line :
City : WARRIORS MARK
State : PA
Zip : 16877-6121
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1800 E PARK AVE
Second Line :
City : STATE COLLEGE
State : PA
Zip : 16803-6701
Country : US
Telephone Number : 814-231-7000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2014
Last Update Date : 05/28/2026

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Directions to “ ASHLEY NICOLE EVICK CRNA” Practice Location

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