Provider Demographics
NPI:1154751311
Name:DERBY, ASHLEY N (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:DERBY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 POINTE NORTH DR
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-7952
Mailing Address - Country:US
Mailing Address - Phone:678-721-0705
Mailing Address - Fax:
Practice Address - Street 1:21 POINTE NORTH DR
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-7952
Practice Address - Country:US
Practice Address - Phone:678-721-0705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN230271363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care