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General NPI Number Information
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NPI Number | 1205380805
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Entity Type | Individual
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Provider Name | ASHLEY NICOLE WHITLOW NNP- BC
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Gender | Female
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Dates
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Enumeration Date | 08/11/2016
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 1906 BELLEVIEW AVE SE 14 SOUTH
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City | ROANOKE
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State | VA
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Zip | 24014-1838
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Country | US
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Telephone | 540-266-6012
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Fax |
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Provider Business Mailing Address
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Address Line | 481 GUILFORD CIR
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City | MARIETTA
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State | GA
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Zip | 30068-3032
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Country | US
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Telephone | 276-252-4966
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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 | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 0024173761
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | RN275966
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License Number State | GA
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