Provider Demographics
NPI:1063008258
Name:FERRELL, ASHLEY BETH
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BETH
Last Name:FERRELL
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 1:10485 E 124TH PL S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3486
Mailing Address - Country:US
Mailing Address - Phone:918-978-6922
Mailing Address - Fax:
Practice Address - Street 1:9411 S DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-5614
Practice Address - Country:US
Practice Address - Phone:918-299-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-12
Last Update Date:2020-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13312183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist