Healthcare Provider Details

I. General information

NPI: 1255839551
Provider Name (Legal Business Name): ASHLEY THORNBURG FINCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2018
Last Update Date: 07/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3480 WAKE FOREST RD STE 310
RALEIGH NC
27609-7376
US

IV. Provider business mailing address

120 SAINT ALBANS DR APT 303
RALEIGH NC
27609-5814
US

V. Phone/Fax

Practice location:
  • Phone: 919-862-5650
  • Fax: 919-862-2677
Mailing address:
  • Phone: 704-502-3973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0010-07757
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: