Healthcare Provider Details

I. General information

NPI: 1982326971
Provider Name (Legal Business Name): ASHTON ELISABETH FULLMER DNP, CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY DR
HERSHEY PA
17033-2360
US

IV. Provider business mailing address

1995 TECHNOLOGY PKWY
MECHANICSBURG PA
17050-8522
US

V. Phone/Fax

Practice location:
  • Phone: 717-531-6597
  • Fax:
Mailing address:
  • Phone: 717-782-5118
  • Fax: 717-782-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN684804
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: