Provider Demographics
NPI:1063440402
Name:ASHBY, TERRANCE CHARLES (ANP)
Entity type:Individual
Prefix:
First Name:TERRANCE
Middle Name:CHARLES
Last Name:ASHBY
Suffix:
Gender:M
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15109
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28408-5109
Mailing Address - Country:US
Mailing Address - Phone:910-392-2525
Mailing Address - Fax:910-392-2827
Practice Address - Street 1:1709 S 16TH ST STE A
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6491
Practice Address - Country:US
Practice Address - Phone:910-452-8633
Practice Address - Fax:910-452-8569
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC110799363LA2200X
NC900170363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC51857OtherBLUE CROSS BLUE SHIELD NC
NC2599490AMedicare PIN
NC51857OtherBLUE CROSS BLUE SHIELD NC