Provider Demographics
NPI:1225278393
Name:BELL, ASHLEY MICHELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:MICHELLE
Last Name:BELL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:STRUCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 WELLSTAR WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8952
Mailing Address - Country:US
Mailing Address - Phone:678-494-2500
Mailing Address - Fax:678-494-2629
Practice Address - Street 1:1120 WELLSTAR WAY STE 105
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30114-8952
Practice Address - Country:US
Practice Address - Phone:678-494-2500
Practice Address - Fax:678-494-2629
Is Sole Proprietor?:No
Enumeration Date:2009-03-02
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA003182363A00000X
GA005106363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA325414FLTMedicare PIN