Provider Demographics
NPI:1225712458
Name:ROULEAU, ASHLEY BRIDGET (PA-C)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BRIDGET
Last Name:ROULEAU
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 BEESLEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-3617
Mailing Address - Country:US
Mailing Address - Phone:413-306-8852
Mailing Address - Fax:
Practice Address - Street 1:30 LOCUST ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2093
Practice Address - Country:US
Practice Address - Phone:413-582-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-08
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant