Healthcare Provider Details

I. General information

NPI: 1346501947
Provider Name (Legal Business Name): ASHLEIGH OLIVER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 BELLEVIEW AVE SE
ROANOKE VA
24014-1838
US

IV. Provider business mailing address

705 MIRIAM HILL DR
ROCKY MOUNT VA
24151-6298
US

V. Phone/Fax

Practice location:
  • Phone: 540-981-7000
  • Fax: 540-981-8429
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110003785
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: