Healthcare Provider Details

I. General information

NPI: 1174435986
Provider Name (Legal Business Name): ASHLEY N MASSEY CPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 OAK DR SE
ATLANTA GA
30354-2839
US

IV. Provider business mailing address

440 OAK DR SE
ATLANTA GA
30354-2839
US

V. Phone/Fax

Practice location:
  • Phone: 386-383-6939
  • Fax:
Mailing address:
  • Phone: 386-383-6939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number26-CPT631
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: