Provider Demographics
NPI:1114198637
Name:MARASS, ASHLEY DENISE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:DENISE
Last Name:MARASS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 40480
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36640-0480
Mailing Address - Country:US
Mailing Address - Phone:251-410-5437
Mailing Address - Fax:251-434-5037
Practice Address - Street 1:1601 CENTER ST
Practice Address - Street 2:STE 1S
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604-1512
Practice Address - Country:US
Practice Address - Phone:251-410-5437
Practice Address - Fax:251-434-5037
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN174021363LP0200X
AL1-125048363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics