Healthcare Provider Details

I. General information

NPI: 1346977360
Provider Name (Legal Business Name): ASHLEIGH MACKEY PCPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2022
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1103 VILLAGE SQUARE DR STE 202
PERRYSBURG OH
43551-1762
US

IV. Provider business mailing address

2222 CHERRY ST STE 1900
TOLEDO OH
43608-2673
US

V. Phone/Fax

Practice location:
  • Phone: 419-872-3243
  • Fax:
Mailing address:
  • Phone: 419-251-3878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN.CNP.0031834
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: