Healthcare Provider Details

I. General information

NPI: 1295129336
Provider Name (Legal Business Name): ASHLEY GUTHRIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 03/28/2022
Certification Date: 07/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HEALTH PARK DR STE 420
BRENTWOOD TN
37027-5721
US

IV. Provider business mailing address

1001 HEALTH PARK DR STE 420
BRENTWOOD TN
37027-5721
US

V. Phone/Fax

Practice location:
  • Phone: 615-880-9500
  • Fax:
Mailing address:
  • Phone: 615-880-9500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number394243
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number63091
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: