Healthcare Provider Details

I. General information

NPI: 1285248591
Provider Name (Legal Business Name): ASHLEY WARD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2020
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N STATE OF FRANKLIN RD STE 12
JOHNSON CITY TN
37604-6048
US

IV. Provider business mailing address

408 N STATE OF FRANKLIN RD STE 12
JOHNSON CITY TN
37604-6048
US

V. Phone/Fax

Practice location:
  • Phone: 423-431-2650
  • Fax: 423-431-2659
Mailing address:
  • Phone: 423-431-2650
  • Fax: 423-431-2659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number28178
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: