Healthcare Provider Details

I. General information

NPI: 1689221756
Provider Name (Legal Business Name): ASHLEY NICOLE MCDORMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2019
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13737 SPOTSWOOD TRL
ELKTON VA
22827-3200
US

IV. Provider business mailing address

PO BOX 1430
HARRISONBURG VA
22803-1430
US

V. Phone/Fax

Practice location:
  • Phone: 540-713-4100
  • Fax: 844-305-8671
Mailing address:
  • Phone: 540-713-4100
  • Fax: 844-305-8671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178093
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: