Provider Demographics
NPI:1083858559
Name:PUTNEY, ASHLEY HOLLAND (PNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:HOLLAND
Last Name:PUTNEY
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1606 WELLINGTON AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-7747
Mailing Address - Country:US
Mailing Address - Phone:910-452-1999
Mailing Address - Fax:910-452-1883
Practice Address - Street 1:1606 WELLINGTON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-7747
Practice Address - Country:US
Practice Address - Phone:910-452-1999
Practice Address - Fax:910-452-1883
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC300358363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1346486891OtherGROUP NPI
NC8943705OtherBCBS OF NC
NC43705Medicaid