Provider Demographics
NPI:1285066415
Name:CROCKER, ASHLEY W (CRNA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:W
Last Name:CROCKER
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:3155 N POINT PKWY STE F100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5495
Mailing Address - Country:US
Mailing Address - Phone:770-645-9181
Mailing Address - Fax:770-645-8455
Practice Address - Street 1:677 CHURCH ST NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1101
Practice Address - Country:US
Practice Address - Phone:770-794-0477
Practice Address - Fax:770-784-3108
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2019-08-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN195083367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered