Provider Demographics
NPI:1215646203
Name:CUDNIK, ASHLEY LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:CUDNIK
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:379 DIXMYTH AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45220-2475
Mailing Address - Country:US
Mailing Address - Phone:513-246-7560
Mailing Address - Fax:513-853-9000
Practice Address - Street 1:379 DIXMYTH AVE FL 8
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45220-2475
Practice Address - Country:US
Practice Address - Phone:513-246-7560
Practice Address - Fax:513-853-9000
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-17
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.007666RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant