Provider Demographics
NPI:1306976402
Name:MANNELL, ASHLEY LLEWELLYN (RD, RN, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:LLEWELLYN
Last Name:MANNELL
Suffix:
Gender:F
Credentials:RD, RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5206 MARKEL RD STE 104
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-3044
Mailing Address - Country:US
Mailing Address - Phone:804-307-4896
Mailing Address - Fax:804-510-0335
Practice Address - Street 1:5206 MARKEL RD STE 104
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3044
Practice Address - Country:US
Practice Address - Phone:804-307-4896
Practice Address - Fax:804-510-0335
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANO LICENSING133V00000X
VA0024170219363LP0808X
VA0001229549163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine