1801852546 NPI number — MRS. KIRSTEN L ASHBY CRNA

Table of content: MRS. KIRSTEN L ASHBY CRNA (NPI 1801852546)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801852546 NPI number — MRS. KIRSTEN L ASHBY CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASHBY
Provider First Name:
KIRSTEN
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801852546
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 180
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMPBELLSVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42719-0180
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-932-3694
Provider Business Mailing Address Fax Number:
270-932-2154

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 OLD LEBANON ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMPBELLSVILLE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42718
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-932-3694
Provider Business Practice Location Address Fax Number:
270-932-2154
Provider Enumeration Date:
04/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  1091045 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00000247358 . This is a "BCBS" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".
  • Identifier: 74005935 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9214 . This is a "BLUEGRASS FAMILY HEALTH" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".