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General NPI Number Information
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NPI Number | 1205545639
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Entity Type | Individual
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Provider Name | ASHLEY DAWN SUGGS APRN
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Gender | Female
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Dates
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Enumeration Date | 11/15/2022
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 1204 W 10TH ST
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City | METROPOLIS
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State | IL
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Zip | 62960-2480
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Country | US
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Telephone | 618-524-3572
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Fax |
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Provider Business Mailing Address
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Address Line | 3704 STRAWBERRY RD
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City | BROOKPORT
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State | IL
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Zip | 62910-2328
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Country | US
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Telephone | 618-638-3775
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 209.026202
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License Number State | IL
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