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General NPI Number Information
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NPI Number | 1164247771
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Entity Type | Individual
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Provider Name | ASHLEY LOSS
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 04/09/2025
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Provider Practice Location Address
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Address Line | 805 N WHITTINGTON PKWY # 40222
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City | LOUISVILLE
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State | KY
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Zip | 40222-7101
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Country | US
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Telephone | 724-470-7132
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Fax |
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Provider Business Mailing Address
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Address Line | 1431 ELIZABETH STREET
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City | SCRANTON
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State | PA
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Zip | 18504
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Country | US
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Telephone | 570-396-3312
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | PN310901
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License Number State | PA
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