Provider Demographics
NPI:1104169507
Name:GILCHRIST, ASHLEY ROSE (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSE
Last Name:GILCHRIST
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9616 GEORGETOWN PIKE
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:VA
Mailing Address - Zip Code:22066-2638
Mailing Address - Country:US
Mailing Address - Phone:703-678-6300
Mailing Address - Fax:
Practice Address - Street 1:1831 WIEHLE AVE
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5266
Practice Address - Country:US
Practice Address - Phone:703-709-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004097363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical