Healthcare Provider Details

I. General information

NPI: 1386973667
Provider Name (Legal Business Name): ASHLEY ELIZABETH BROWN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2009
Last Update Date: 12/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 MALLOCH RD
CHURCHVILLE NY
14428-9450
US

IV. Provider business mailing address

338 MALLOCH RD PO BOX 35
CHURCHVILLE NY
14428-9450
US

V. Phone/Fax

Practice location:
  • Phone: 585-747-8471
  • Fax:
Mailing address:
  • Phone: 585-747-8471
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number34282460709E
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: