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NPI Code Detail

MEDICARE: ASHLEY DEGUTIS NP

MEDICARE: ASHLEY DEGUTIS NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner16714OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003212382
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY DEGUTIS NP
Provider Business Mailing Address
First Line : 90 JACKSON PIKE
Second Line :
City : GALLIPOLIS
State : OH
Zip : 45631-1560
Country : US
Telephone Number : 855-446-5937
Fax Number : 740-395-8506
Provider Business Practice Location Address
First Line : 1560 S HIGH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43207-1803
Country : US
Telephone Number : 614-274-1455
Fax Number : 614-274-1433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2014
Last Update Date : 11/20/2023

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