Provider Demographics
NPI:1164492286
Name:ASHBY, ELIZABETH ANNE GERDUN (CPNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANNE GERDUN
Last Name:ASHBY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 WASHINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-3668
Mailing Address - Country:US
Mailing Address - Phone:252-466-0242
Mailing Address - Fax:252-466-0159
Practice Address - Street 1:PSC BOX 8023
Practice Address - Street 2:NAVAL HOSPITAL
Practice Address - City:CHERRY POINT
Practice Address - State:NC
Practice Address - Zip Code:28533
Practice Address - Country:US
Practice Address - Phone:252-466-0242
Practice Address - Fax:252-466-0159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN309367L363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics