Provider Demographics
NPI:1346088895
Name:KORENKIEWICZ, ASHLEY B (MS, RN, L AC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:KORENKIEWICZ
Suffix:
Gender:F
Credentials:MS, RN, L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 WOODLAND SHORE DR
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04274-6113
Mailing Address - Country:US
Mailing Address - Phone:207-838-0469
Mailing Address - Fax:
Practice Address - Street 1:75 WOODLAND SHORE DR
Practice Address - Street 2:
Practice Address - City:POLAND
Practice Address - State:ME
Practice Address - Zip Code:04274-6113
Practice Address - Country:US
Practice Address - Phone:207-838-0469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEAC814171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist