Provider Demographics
NPI:1235777038
Name:THOMAS, ASHLEY
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 SW HIGHWAY 484 STE 105
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34473-1996
Mailing Address - Country:US
Mailing Address - Phone:352-693-5900
Mailing Address - Fax:352-693-5805
Practice Address - Street 1:1665 SW HIGHWAY 484 STE 105
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34473-1996
Practice Address - Country:US
Practice Address - Phone:352-693-5900
Practice Address - Fax:352-693-5805
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-12
Last Update Date:2022-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11005265363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner