Provider Demographics
NPI:1396141842
Name:GARCIA, ASHLY
Entity type:Individual
Prefix:
First Name:ASHLY
Middle Name:
Last Name:GARCIA
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 1:129 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:BLOOMING PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55917-1242
Mailing Address - Country:US
Mailing Address - Phone:507-413-3908
Mailing Address - Fax:
Practice Address - Street 1:129 4TH ST NE
Practice Address - Street 2:
Practice Address - City:BLOOMING PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55917-1242
Practice Address - Country:US
Practice Address - Phone:507-413-3908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-11
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2211635163WH0200X, 163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH0200XNursing Service ProvidersRegistered NurseHome Health