Provider Demographics
NPI:1154005429
Name:NELSON, ASHLEY NICHOLE (RDH)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:NELSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MISS
Other - First Name:ASHLEY
Other - Middle Name:NICHOLE
Other - Last Name:THURLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDH
Mailing Address - Street 1:142 N DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66503-3094
Mailing Address - Country:US
Mailing Address - Phone:785-410-5639
Mailing Address - Fax:
Practice Address - Street 1:1305 WESTLOOP PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-2841
Practice Address - Country:US
Practice Address - Phone:785-539-5949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12087124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist