Provider Demographics
NPI:1588353577
Name:BAXTER, ASHELY SLABAUGH (LM)
Entity type:Individual
Prefix:
First Name:ASHELY
Middle Name:SLABAUGH
Last Name:BAXTER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1924 VERANO RD
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92617-3123
Mailing Address - Country:US
Mailing Address - Phone:770-807-9242
Mailing Address - Fax:
Practice Address - Street 1:1924 VERANO RD
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92617-3123
Practice Address - Country:US
Practice Address - Phone:770-807-9242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM697176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife