Provider Demographics
NPI:1003298274
Name:NIX, ASHLEY (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:NIX
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 GEORGIA AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29841-3849
Mailing Address - Country:US
Mailing Address - Phone:803-202-3351
Mailing Address - Fax:
Practice Address - Street 1:447 N BELAIR RD STE 101
Practice Address - Street 2:
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3091
Practice Address - Country:US
Practice Address - Phone:706-854-2222
Practice Address - Fax:706-854-2226
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007711363L00000X
SC20563363LF0000X
GA236796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5007711OtherNURSE PRACTITIONER LICENSE
GA236796OtherGEORGIA APRN
SC20563OtherAPRN SC