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General NPI Number Information
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NPI Number | 1013587724
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Entity Type | Individual
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Provider Name | ASHLEY ELIZABETH NEEDHAM FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2021
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Last Update Date | 02/05/2022
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Provider Practice Location Address
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Address Line | 37767 MARKET DR UNIT 200
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City | CHARLOTTE HALL
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State | MD
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Zip | 20622-3199
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Country | US
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Telephone | 301-884-2062
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Fax |
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Provider Business Mailing Address
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Address Line | 29161 HEARTS DESIRE DR
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City | MECHANICSVILLE
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State | MD
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Zip | 20659-4749
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Country | US
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Telephone | 240-434-1158
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R199683
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License Number State | MD
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