Provider Demographics
NPI:1962265579
Name:THOMAS, ASHLEY L (CRNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:L
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HEMLOCK RD
Mailing Address - Street 2:
Mailing Address - City:UNITYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17774-9136
Mailing Address - Country:US
Mailing Address - Phone:570-974-5739
Mailing Address - Fax:
Practice Address - Street 1:131 W EDWIN ST
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6131
Practice Address - Country:US
Practice Address - Phone:570-505-8331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP029124363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily