1730151408 NPI number — MRS. ASHLEY KENT STONE CPNP-PC

Table of content: MRS. ASHLEY KENT STONE CPNP-PC (NPI 1730151408)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730151408 NPI number — MRS. ASHLEY KENT STONE CPNP-PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STONE
Provider First Name:
ASHLEY
Provider Middle Name:
KENT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CPNP-PC
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:
1730151408
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3101 SE 14TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BENTONVILLE
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72712-4900
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-636-9234
Provider Business Mailing Address Fax Number:
479-636-0774

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 SE 14TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BENTONVILLE
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72712-4900
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-636-9234
Provider Business Practice Location Address Fax Number:
479-636-0774
Provider Enumeration Date:
02/06/2006

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: 363LP0200X , with the licence number:  R83339 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LP0200X , with the licence number: A003236 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 320423500 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 132173 . This is a "UCARE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 180931758 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 823S7ST . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1202882 . This is a "MEDICA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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