Healthcare Provider Details

I. General information

NPI: 1265142475
Provider Name (Legal Business Name): ASHLEY STANLEY FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ASHLEY NICOLE WOODS RN

II. Dates (important events)

Enumeration Date: 11/29/2022
Last Update Date: 11/29/2022
Certification Date: 10/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23743 DICKENSON HWY
HAYSI VA
24256
US

IV. Provider business mailing address

245 LIZA FLTS
HAYSI VA
24256-6290
US

V. Phone/Fax

Practice location:
  • Phone: 276-865-7811
  • Fax:
Mailing address:
  • Phone: 276-218-0477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024185831
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: