Healthcare Provider Details

I. General information

NPI: 1396501953
Provider Name (Legal Business Name): ASHLEY MARIE SIGMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/22/2024
Certification Date: 02/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

244 W STURBRIDGE DR
MEDINA OH
44256-3887
US

IV. Provider business mailing address

5872 WEDGEWOOD RD
MEDINA OH
44256-7858
US

V. Phone/Fax

Practice location:
  • Phone: 330-635-4954
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: