Healthcare Provider Details

I. General information

NPI: 1558091637
Provider Name (Legal Business Name): ASHLEY LYNN SWEETS AU.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2022
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 KENTUCKY AVE STE 601
PADUCAH KY
42003-3806
US

IV. Provider business mailing address

2605 KENTUCKY AVE STE 601
PADUCAH KY
42003-3806
US

V. Phone/Fax

Practice location:
  • Phone: 270-408-4368
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: