Provider Demographics
NPI:1043776461
Name:ASHINGHURST, AMY L
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:L
Last Name:ASHINGHURST
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 1:35C GRIMES RD APT 202
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2430
Mailing Address - Country:US
Mailing Address - Phone:860-918-3083
Mailing Address - Fax:860-469-5311
Practice Address - Street 1:2934 MAIN ST UPPR LEVEL
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-1027
Practice Address - Country:US
Practice Address - Phone:860-815-7535
Practice Address - Fax:860-469-5311
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist