Healthcare Provider Details

I. General information

NPI: 1902631146
Provider Name (Legal Business Name): ASHLEY WORLEY CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 ELECTRIC RD STE 1030
SALEM VA
24153-7474
US

IV. Provider business mailing address

3630 CHAR LENA LN
PULASKI VA
24301-7495
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-3650
  • Fax:
Mailing address:
  • Phone: 540-320-4728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number0024191128
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: