Provider Demographics
NPI:1265019962
Name:PACHOWICZ, ASHLEY (CNA, HHA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PACHOWICZ
Suffix:
Gender:F
Credentials:CNA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12348 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-7907
Mailing Address - Country:US
Mailing Address - Phone:219-682-8783
Mailing Address - Fax:
Practice Address - Street 1:12348 BROOKSIDE DR
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-7907
Practice Address - Country:US
Practice Address - Phone:219-682-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-27
Last Update Date:2021-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INHHA1100351374U00000X
INCNA0803793376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide