Provider Demographics
NPI:1972111458
Name:LEVY, ASHLEY MAUREEN (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:MAUREEN
Last Name:LEVY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 LAKESHORE DR STE B
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:GA
Mailing Address - Zip Code:31558-3859
Mailing Address - Country:US
Mailing Address - Phone:912-882-4254
Mailing Address - Fax:888-512-9114
Practice Address - Street 1:100 LAKESHORE DR STE B
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:GA
Practice Address - Zip Code:31558-3859
Practice Address - Country:US
Practice Address - Phone:912-882-4254
Practice Address - Fax:888-512-9114
Is Sole Proprietor?:No
Enumeration Date:2020-07-21
Last Update Date:2020-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN285822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily