Healthcare Provider Details

I. General information

NPI: 1215174172
Provider Name (Legal Business Name): ASHLEY SUMNER R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6001 SUMMIT VIEW LN
CRESTWOOD KY
40014-9621
US

IV. Provider business mailing address

6001 SUMMIT VIEW LN
CRESTWOOD KY
40014-9621
US

V. Phone/Fax

Practice location:
  • Phone: 502-550-7616
  • Fax:
Mailing address:
  • Phone: 502-550-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number2121
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: