Provider Demographics
NPI:1972612182
Name:DOHRN, ASHLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DOHRN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:SCHORGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28209 230TH STREET CT
Mailing Address - Street 2:
Mailing Address - City:LE CLAIRE
Mailing Address - State:IA
Mailing Address - Zip Code:52753-9262
Mailing Address - Country:US
Mailing Address - Phone:563-650-1459
Mailing Address - Fax:
Practice Address - Street 1:129 W. LOCUST ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803
Practice Address - Country:US
Practice Address - Phone:563-324-1641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20345183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA004910Medicaid