Provider Demographics
NPI:1316706005
Name:LAPRADE, ASHLEY (MS)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:LAPRADE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 WATERMAN RD N
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5242
Mailing Address - Country:US
Mailing Address - Phone:817-542-4565
Mailing Address - Fax:
Practice Address - Street 1:977 WATERMAN RD N
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5242
Practice Address - Country:US
Practice Address - Phone:817-542-4565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist