Healthcare Provider Details

I. General information

NPI: 1457835399
Provider Name (Legal Business Name): ASHLEY NICHOLE TOLLFREE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2018
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2461 HUMMINGBIRD DR
GREENVILLE MS
38701-8108
US

IV. Provider business mailing address

2461 HUMMINGBIRD DR
GREENVILLE MS
38701-8108
US

V. Phone/Fax

Practice location:
  • Phone: 662-394-9155
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number902704
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number902704
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: