Provider Demographics
NPI:1063986131
Name:NICHOLS, ASHLEY ADRIENNE (BC-HIS)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:ADRIENNE
Last Name:NICHOLS
Suffix:
Gender:F
Credentials:BC-HIS
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:ADRIENNE
Other - Last Name:REECE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BC-A HIS
Mailing Address - Street 1:2501 COTTONTAIL LN
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5125
Mailing Address - Country:US
Mailing Address - Phone:732-960-6436
Mailing Address - Fax:252-689-6029
Practice Address - Street 1:915 S MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-4700
Practice Address - Country:US
Practice Address - Phone:910-276-1125
Practice Address - Fax:910-338-1846
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1570237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1570OtherBOARD CERTIFIED HEARING SPECIALIST