=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336626076
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ASHLEY D RING NP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2018
-----------------------------------------------------
Last Update Date | 07/25/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 612 LOVE AVE
-----------------------------------------------------
City | TIFTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31794-4406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-391-3300
-----------------------------------------------------
Fax | 229-388-1948
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 612 LOVE AVE
-----------------------------------------------------
City | TIFTON
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31794-4406
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 229-391-3300
-----------------------------------------------------
Fax | 229-388-1948
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | RN174136
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------