Healthcare Provider Details

I. General information

NPI: 1992792428
Provider Name (Legal Business Name): SANDRA KAY ASHOFF APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 11/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8915 SHADY GROVE CT
GAITHERSBURG MD
20877-1308
US

IV. Provider business mailing address

913 MEADOWGREEN DR
MOUNT AIRY MD
21771-5679
US

V. Phone/Fax

Practice location:
  • Phone: 301-963-0060
  • Fax:
Mailing address:
  • Phone: 301-831-5089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR083963
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: