Provider Demographics
NPI:1215771753
Name:EARLY, ASHLEY M
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:EARLY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1498 W CUMBERLAND GAP PKWY
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-5902
Mailing Address - Country:US
Mailing Address - Phone:606-280-7875
Mailing Address - Fax:833-974-2501
Practice Address - Street 1:1498 W CUMBERLAND GAP PKWY
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-5902
Practice Address - Country:US
Practice Address - Phone:606-280-7875
Practice Address - Fax:833-974-2501
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4022771363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily