Healthcare Provider Details

I. General information

NPI: 1669296026
Provider Name (Legal Business Name): ASHLEY COVINGTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024
Certification Date: 11/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 STATE ST
ALBANY NY
12207-2512
US

IV. Provider business mailing address

69 STATE ST
ALBANY NY
12207-2512
US

V. Phone/Fax

Practice location:
  • Phone: 832-714-1004
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number765732
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number1010429
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number765732
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: