Healthcare Provider Details

I. General information

NPI: 1104223809
Provider Name (Legal Business Name): ASHLEY THOMAS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/24/2014
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

854 S WHITE HORSE PIKE UNIT 4
HAMMONTON NJ
08037-2033
US

IV. Provider business mailing address

854 S WHITE HORSE PIKE UNIT 4
HAMMONTON NJ
08037-2033
US

V. Phone/Fax

Practice location:
  • Phone: 609-704-0185
  • Fax: 609-704-0195
Mailing address:
  • Phone: 609-704-0185
  • Fax: 609-704-0195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00533500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: