Provider Demographics
NPI:1124385885
Name:CODDING, ASHLEY MARIE HALE (PA-C, RD/LD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIE HALE
Last Name:CODDING
Suffix:
Gender:F
Credentials:PA-C, RD/LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8325 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6006
Mailing Address - Country:US
Mailing Address - Phone:405-749-7099
Mailing Address - Fax:405-757-3711
Practice Address - Street 1:8325 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-6006
Practice Address - Country:US
Practice Address - Phone:405-749-7099
Practice Address - Fax:405-757-3711
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1841133V00000X
OK2590363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered