Provider Demographics
NPI:1215363528
Name:DAVIS, ASHLEY WAITE (FNP-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:WAITE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1434 BOYD GALLOWAY RD
Mailing Address - Street 2:
Mailing Address - City:GRIMESLAND
Mailing Address - State:NC
Mailing Address - Zip Code:27837-9071
Mailing Address - Country:US
Mailing Address - Phone:607-742-8038
Mailing Address - Fax:252-413-0857
Practice Address - Street 1:2455 EMERALD PL
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5785
Practice Address - Country:US
Practice Address - Phone:252-758-2224
Practice Address - Fax:252-413-0857
Is Sole Proprietor?:No
Enumeration Date:2013-09-18
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006744363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily