Provider Demographics
NPI:1134687023
Name:PERRINE, ASHLEY JANE (RN)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:JANE
Last Name:PERRINE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 FRONT AVE SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-3623
Mailing Address - Country:US
Mailing Address - Phone:330-243-4329
Mailing Address - Fax:
Practice Address - Street 1:717 DALE AVE NW
Practice Address - Street 2:
Practice Address - City:STRASBURG
Practice Address - State:OH
Practice Address - Zip Code:44680-9736
Practice Address - Country:US
Practice Address - Phone:330-243-4329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-09
Last Update Date:2019-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH454231163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse