Healthcare Provider Details

I. General information

NPI: 1205759990
Provider Name (Legal Business Name): ASHLEE WALSH EMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 KOHLMYER DR
PENNSAUKEN NJ
08110-1248
US

IV. Provider business mailing address

112 KOHLMYER DR
PENNSAUKEN NJ
08110-1248
US

V. Phone/Fax

Practice location:
  • Phone: 609-218-2021
  • Fax:
Mailing address:
  • Phone: 609-218-2021
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number651871
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: