Healthcare Provider Details

I. General information

NPI: 1336890359
Provider Name (Legal Business Name): SAMMIE K ASHLEY CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2022
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 4TH ST
ALEXANDRIA LA
71301-8421
US

IV. Provider business mailing address

5221 FAIRVIEW AVE
ALEXANDRIA LA
71303-2481
US

V. Phone/Fax

Practice location:
  • Phone: 318-442-5399
  • Fax: 318-442-1596
Mailing address:
  • Phone: 337-831-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number223878
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: