Provider Demographics
NPI:1235465600
Name:MARTIN, ASHLEY D (NP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:D
Last Name:MARTIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Mailing Address - Street 1:18 FOUNDRY ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301-5421
Mailing Address - Country:US
Mailing Address - Phone:603-230-5627
Mailing Address - Fax:603-230-5601
Practice Address - Street 1:18 FOUNDRY ST
Practice Address - Street 2:SUITE 103
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301-5421
Practice Address - Country:US
Practice Address - Phone:603-230-5627
Practice Address - Fax:603-230-5601
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2015-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NH061485-23363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30347793Medicaid
NH30347793Medicaid