Healthcare Provider Details

I. General information

NPI: 1346676475
Provider Name (Legal Business Name): ASHLEY M BJORK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2013
Last Update Date: 09/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 S MAPLE ST
MURFREESBORO TN
37130-3530
US

IV. Provider business mailing address

130 S MAPLE ST
MURFREESBORO TN
37130-3530
US

V. Phone/Fax

Practice location:
  • Phone: 615-217-4770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2395
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: