Provider Demographics
NPI:1225217672
Name:ISAAC-DOCKERY, ASHLEY M (APRN,BC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:ISAAC-DOCKERY
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:ISAAC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN--BC
Mailing Address - Street 1:PO BOX 13007
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28052-0040
Mailing Address - Country:US
Mailing Address - Phone:704-864-8772
Mailing Address - Fax:704-866-7853
Practice Address - Street 1:1550 UNION RD STE B
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-5522
Practice Address - Country:US
Practice Address - Phone:704-864-8772
Practice Address - Fax:704-866-7853
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007004617363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health