Healthcare Provider Details

I. General information

NPI: 1649961947
Provider Name (Legal Business Name): ASHLEY ROSS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2023
Last Update Date: 05/17/2023
Certification Date: 05/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 VERMONT AVE NW
WASHINGTON DC
20420-0001
US

IV. Provider business mailing address

810 VERMONT AVE NW
WASHINGTON DC
20420-0001
US

V. Phone/Fax

Practice location:
  • Phone: 904-322-4480
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN9297532
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: