Provider Demographics
NPI:1285315606
Name:MCCRAY, ASHLEY ROSS
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ROSS
Last Name:MCCRAY
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 1:2150 SOUTEL DR # 12
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-2281
Mailing Address - Country:US
Mailing Address - Phone:904-434-6875
Mailing Address - Fax:904-467-3297
Practice Address - Street 1:2150 SOUTEL DR # 12
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-2281
Practice Address - Country:US
Practice Address - Phone:904-434-6875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-27
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2287304247ZC0005X
251C00000X, 347C00000X, 376J00000X, 3747P1801X
FL239587376J00000X, 372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physicianGroup - Single Specialty
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No347C00000XTransportation ServicesPrivate Vehicle
No376J00000XNursing Service Related ProvidersHomemaker
Yes372600000XNursing Service Related ProvidersAdult Companion