Healthcare Provider Details

I. General information

NPI: 1063362457
Provider Name (Legal Business Name): ASHLEY MCNALLY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY CHARETTE

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 LANSING ST
AUBURN NY
13021-1983
US

IV. Provider business mailing address

4859 TWELVE CORNERS RD
OWASCO NY
13021-9626
US

V. Phone/Fax

Practice location:
  • Phone: 315-255-7011
  • Fax:
Mailing address:
  • Phone: 315-657-8118
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number002515
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: