Provider Demographics
NPI:1992323745
Name:MARTIN, ASHLEY OLIVIA (NP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:OLIVIA
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 FLORA AVE
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-6615
Mailing Address - Country:US
Mailing Address - Phone:401-426-0570
Mailing Address - Fax:
Practice Address - Street 1:191 SOCIAL ST
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-3240
Practice Address - Country:US
Practice Address - Phone:401-597-6500
Practice Address - Fax:401-597-6509
Is Sole Proprietor?:No
Enumeration Date:2020-07-08
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02378363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Single Specialty