Provider Demographics
NPI:1194248518
Name:WILLARD, S. ASHLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:S.
Middle Name:ASHLEY
Last Name:WILLARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:SHENA
Other - Middle Name:ASHLEY
Other - Last Name:WILLARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2495 OLD TAYLOR RD UNIT 206
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5181
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2495 OLD TAYLOR RD UNIT 206
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5181
Practice Address - Country:US
Practice Address - Phone:210-286-0690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2023-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-13928183500000X
TN42426183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist