Healthcare Provider Details

I. General information

NPI: 1669036596
Provider Name (Legal Business Name): ASHLEY NICOLE CROSS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2019
Last Update Date: 11/25/2024
Certification Date: 11/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 CURTIS PKWY NE STE 1
CALHOUN GA
30701-2062
US

IV. Provider business mailing address

PO BOX 12938
CALHOUN GA
30703-7013
US

V. Phone/Fax

Practice location:
  • Phone: 706-879-5770
  • Fax: 706-624-4336
Mailing address:
  • Phone: 706-602-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000233718
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberGAA-CNM002881
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: