Provider Demographics
NPI:1558081786
Name:SHINKLE, ASHLEY DAWN
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:DAWN
Last Name:SHINKLE
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 1:1541 HOCKING VALLEY PL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-8123
Mailing Address - Country:US
Mailing Address - Phone:740-542-1504
Mailing Address - Fax:
Practice Address - Street 1:1541 HOCKING VALLEY PL
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8123
Practice Address - Country:US
Practice Address - Phone:740-542-1504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH101YA0400XMedicaid