Provider Demographics
NPI:1063141208
Name:WOMACK, ASHLEY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:WOMACK
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 CAPITOL TRL STE 1203
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-5709
Mailing Address - Country:US
Mailing Address - Phone:302-308-7711
Mailing Address - Fax:267-609-8264
Practice Address - Street 1:1423 CAPITOL TRL STE 1203
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-5709
Practice Address - Country:US
Practice Address - Phone:302-308-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-05
Last Update Date:2024-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP025787363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health