Provider Demographics
NPI:1093714875
Name:DAUGHENBAUGH, ASHLEY MARIA (CRNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIA
Last Name:DAUGHENBAUGH
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 STATE ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16507-1427
Mailing Address - Country:US
Mailing Address - Phone:814-456-4241
Mailing Address - Fax:814-453-3354
Practice Address - Street 1:300 STATE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507-1427
Practice Address - Country:US
Practice Address - Phone:814-456-4241
Practice Address - Fax:814-453-3354
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP007019B363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner