MEDICARE: MS. S. L. ASHWORTH APRN-BC

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
1	363LF0000X	Family Nurse Practitioner	RN080564NP	GA

General Provider Information

NPI Number	:	1457550543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. S. L. ASHWORTH APRN-BC

Provider Business Mailing Address
First Line	:	PO BOX 903
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-0903
Country	:	US
Telephone Number	:	770-789-8120
Fax Number	:

Provider Business Practice Location Address
First Line	:	4278 SPRINGDALE CIR
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-1961
Country	:	US
Telephone Number	:	770-789-8120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2007
Last Update Date	:	07/22/2011

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