Provider Demographics
NPI:1588252050
Name:STILLS, ASHLEY ELIZABETH (CPM, CDEM)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:ELIZABETH
Last Name:STILLS
Suffix:
Gender:F
Credentials:CPM, CDEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 N WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:ETNA GREEN
Mailing Address - State:IN
Mailing Address - Zip Code:46524-9461
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:313 N WALNUT ST
Practice Address - Street 2:
Practice Address - City:ETNA GREEN
Practice Address - State:IN
Practice Address - Zip Code:46524-9461
Practice Address - Country:US
Practice Address - Phone:574-213-1136
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-09
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN90000016A176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife