Provider Demographics
NPI:1083734974
Name:ASHTON, LISA (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:ASHTON
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 ROSEDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-2747
Mailing Address - Country:US
Mailing Address - Phone:443-253-7341
Mailing Address - Fax:
Practice Address - Street 1:1931 GREENSPRING DR
Practice Address - Street 2:
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-4113
Practice Address - Country:US
Practice Address - Phone:410-453-9553
Practice Address - Fax:410-453-9552
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR140286163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR140286OtherSTATE LICENSE NUMBER