NPI Code Detail JSON Logo

1104108604 NPI number — ASHLEE NIKOLE DUDLEY SLP

NPI Number: 1104108604
Health Care Provider/Practitioner: ASHLEE NIKOLE DUDLEY SLP

Information about “1104108604” NPI (ASHLEE NIKOLE DUDLEY SLP) exists in 1104108604 in HTML format HTML  |  1104108604 in plain Text format TXT  |  1104108604 in PDF (Portable Document Format) PDF  |  1104108604 in an XML format XML  formats.

NPI Number : 1104108604 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104108604",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "DUDLEY",
    "FirstName": "ASHLEE",
    "MiddleName": "NIKOLE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "SLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "FRALEY",
    "OtherFirstName": "ASHLEE",
    "OtherMiddleName": "NIKOLE",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "2150 CARTER AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ASHLAND",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "41101-7734",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "502-303-8634",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "12862 KY-180",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ASHLAND",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "41102",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "606-928-5805",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/12/2011",
    "LastUpdateDate": "07/21/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "4396142316",
          "LicenseNumberStateCode": "KY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "235Z00000X",
          "TaxonomyName": "Speech-Language Pathologist",
          "LicenseNumber": "SLP-1461",
          "LicenseNumberStateCode": "WV",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.