Provider Demographics
NPI:1275628547
Name:PRESTON, ASHLEIGH R (PAC)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:R
Last Name:PRESTON
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 82585
Mailing Address - Street 2:CO NEBRASKA HEART INSTITUTE PC
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68501
Mailing Address - Country:US
Mailing Address - Phone:402-489-6554
Mailing Address - Fax:402-328-3797
Practice Address - Street 1:7440 S 91ST ST
Practice Address - Street 2:CO NEBRASKA HEART INSTITUTE PC
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9797
Practice Address - Country:US
Practice Address - Phone:402-489-6554
Practice Address - Fax:402-328-3797
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE1163363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE278634Medicare ID - Type Unspecified
Q41913Medicare UPIN