Provider Demographics
NPI:1063740421
Name:KING, ASHLEIGH MARIE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEIGH
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MISS
Other - First Name:ASHLEIGH
Other - Middle Name:MARIE
Other - Last Name:HEIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:234 N 3RD STREET
Mailing Address - Street 2:UNIT 205
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:909 WALNUT STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107
Practice Address - Country:US
Practice Address - Phone:215-955-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-24
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010496363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care