Provider Demographics
NPI:1306460811
Name:DAVIS, ASHLEY (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 WHITE DIRT RD
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-7646
Mailing Address - Country:US
Mailing Address - Phone:336-366-7611
Mailing Address - Fax:
Practice Address - Street 1:765 HIGHLAND OAKS DR STE 100
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-7100
Practice Address - Country:US
Practice Address - Phone:336-760-4004
Practice Address - Fax:336-760-6632
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC400362174400000X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No174400000XOther Service ProvidersSpecialist