Healthcare Provider Details

I. General information

NPI: 1912882671
Provider Name (Legal Business Name): ASHLEY HELTON
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 OLD MAIN
UNIVERSITY PARK PA
16802
US

IV. Provider business mailing address

1335 DREIBELBIS ST APT 133
STATE COLLEGE PA
16801-7468
US

V. Phone/Fax

Practice location:
  • Phone: 528-481-4865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: