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General NPI Number Information
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NPI Number | 1538618285
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Entity Type | Individual
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Provider Name | ASHLEY ELIZABETH SCAGLIONE PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2016
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Last Update Date | 09/22/2016
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Provider Practice Location Address
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Address Line | 10279 BUSINESS 21
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City | HILLSBORO
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State | MO
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Zip | 63050-3598
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Country | US
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Telephone | 636-789-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 4132 RICEWOOD DR
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City | SAINT LOUIS
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State | MO
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Zip | 63129-2008
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Country | US
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Telephone | 314-609-5349
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 2016033592
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License Number State | MO
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