1225734163 NPI number — ASHLEY SHEEHAN CRNP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225734163 NPI number — ASHLEY SHEEHAN CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEEHAN
Provider First Name:
ASHLEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CRNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JENKINS
Provider Other First Name:
ASHLEY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1225734163
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
201 DEFENSE HWY STE 205
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ANNAPOLIS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21401-7096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
855-527-7246
Provider Business Mailing Address Fax Number:
866-229-5063

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
598 CYNWOOD DR STE 105
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EASTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21601-3875
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
855-527-7246
Provider Business Practice Location Address Fax Number:
866-229-5063
Provider Enumeration Date:
02/02/2023

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:  R186528 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: F12220627 . This is a "AMERICAN ACADEMY OF NURSE PRACTITIONERS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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