1164492286 NPI number — MS. ELIZABETH ANNE GERDUN ASHBY CPNP

Table of content: MS. ELIZABETH ANNE GERDUN ASHBY CPNP (NPI 1164492286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164492286 NPI number — MS. ELIZABETH ANNE GERDUN ASHBY CPNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASHBY
Provider First Name:
ELIZABETH
Provider Middle Name:
ANNE GERDUN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CPNP
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:
1164492286
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4389 BEAUFORT ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHERRY POINT
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
PSC BOX 8023
Provider Second Line Business Practice Location Address:
NAVAL HOSPITAL
Provider Business Practice Location Address City Name:
CHERRY POINT
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-466-0242
Provider Business Practice Location Address Fax Number:
252-466-0159
Provider Enumeration Date:
01/23/2006

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:  RN309367L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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