1891147500 NPI number — ASHLEIGH ELISABETH ADKINS ARNP

Table of content: ASHLEIGH ELISABETH ADKINS ARNP (NPI 1891147500)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891147500 NPI number — ASHLEIGH ELISABETH ADKINS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADKINS
Provider First Name:
ASHLEIGH
Provider Middle Name:
ELISABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MILTON
Provider Other First Name:
ASHLEIGH
Provider Other Middle Name:
ELISABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1891147500
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1400 E KINCAID ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOUNT VERNON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98274-4127
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-814-6451
Provider Business Mailing Address Fax Number:
360-445-8592

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3823 172ND ST NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98223-7735
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-386-3600
Provider Business Practice Location Address Fax Number:
360-386-3699
Provider Enumeration Date:
07/06/2016

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: 363LF0000X , with the licence number:  AP60675857 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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