Healthcare Provider Details

I. General information

NPI: 1366359960
Provider Name (Legal Business Name): ASHLEY BEARRY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5985 N COUNTY ROAD 575 W
SCIPIO IN
47273-9776
US

IV. Provider business mailing address

5985 N COUNTY ROAD 575 W
SCIPIO IN
47273-9776
US

V. Phone/Fax

Practice location:
  • Phone: 812-558-1211
  • Fax:
Mailing address:
  • Phone: 812-558-1211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28216277A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: