Provider Demographics
NPI:1033562228
Name:MCPHERSON, ASHLEY
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:MCPHERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 JEFFERSON DR
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:WV
Mailing Address - Zip Code:26150-7600
Mailing Address - Country:US
Mailing Address - Phone:304-483-7881
Mailing Address - Fax:
Practice Address - Street 1:1506 ELIZABETH PIKE
Practice Address - Street 2:
Practice Address - City:MINERAL WELLS
Practice Address - State:WV
Practice Address - Zip Code:26150-8413
Practice Address - Country:US
Practice Address - Phone:304-489-2710
Practice Address - Fax:304-489-2687
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT0008413183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician