Healthcare Provider Details

I. General information

NPI: 1588189054
Provider Name (Legal Business Name): EMILY ASHTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2017
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 W SECOND ST STE 207
LEXINGTON KY
40508-1268
US

IV. Provider business mailing address

535 W SECOND ST STE 207
LEXINGTON KY
40508-1268
US

V. Phone/Fax

Practice location:
  • Phone: 859-388-9152
  • Fax: 859-255-5385
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number174158
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: