Healthcare Provider Details

I. General information

NPI: 1184592925
Provider Name (Legal Business Name): ASHLEY G DAVIDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2025
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S WATER ST
LOUISA KY
41230-1347
US

IV. Provider business mailing address

125 S MAIN CROSS ST
LOUISA KY
41230-1330
US

V. Phone/Fax

Practice location:
  • Phone: 606-649-2211
  • Fax: 606-638-1399
Mailing address:
  • Phone: 606-638-0938
  • Fax: 859-813-5394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: