Healthcare Provider Details

I. General information

NPI: 1093510463
Provider Name (Legal Business Name): ASHLEY LAUREN PATTERSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E 4TH ST APT 113
WAYNE NE
68787-2248
US

IV. Provider business mailing address

801 E 4TH ST APT 113
WAYNE NE
68787-2248
US

V. Phone/Fax

Practice location:
  • Phone: 308-318-0440
  • Fax:
Mailing address:
  • Phone: 308-318-0440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: