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General NPI Number Information
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NPI Number | 1912629775
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Entity Type | Individual
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Provider Name | ASHLEY PULLEY PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/16/2022
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Last Update Date | 09/16/2022
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Provider Practice Location Address
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Address Line | 2449 HOSPITAL DR STE 200
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City | BOSSIER CITY
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State | LA
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Zip | 71111-1905
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Country | US
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Telephone | 318-212-7841
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Fax |
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Provider Business Mailing Address
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Address Line | 257 LEO AVE
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City | SHREVEPORT
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State | LA
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Zip | 71105-3332
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Country | US
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Telephone | 985-870-2879
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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