Healthcare Provider Details

I. General information

NPI: 1134687023
Provider Name (Legal Business Name): ASHLEY JANE PERRINE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2019
Last Update Date: 03/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 DALE AVE NW
STRASBURG OH
44680-9736
US

IV. Provider business mailing address

443 FRONT AVE SW
NEW PHILADELPHIA OH
44663-3623
US

V. Phone/Fax

Practice location:
  • Phone: 330-243-4329
  • Fax:
Mailing address:
  • Phone: 330-243-4329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number454231
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: