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General NPI Number Information
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NPI Number | 1083348619
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Entity Type | Individual
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Provider Name | LAURA GILLIAN ASHWORTH APRN PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/11/2022
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Last Update Date | 07/11/2022
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Provider Practice Location Address
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Address Line | 26317 WASHINGTON ST
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City | NORTH DINWIDDIE
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State | VA
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Zip | 23803-2727
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Country | US
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Telephone | 804-614-5670
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Fax |
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Provider Business Mailing Address
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Address Line | 8017 WHITTINGTON DR
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23235-4257
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Country | US
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Telephone |
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 0024184657
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License Number State | VA
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