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General NPI Number Information
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NPI Number | 1912247974
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Entity Type | Individual
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Provider Name | JESSICA ASH PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/27/2013
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Last Update Date | 11/17/2023
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Provider Practice Location Address
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Address Line | 12188B N MERIDIAN ST STE 250
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City | CARMEL
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State | IN
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Zip | 46032-4901
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Country | US
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Telephone | 317-705-4825
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Fax | 317-705-4826
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10002340A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 016422
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10002340A
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License Number State | IN
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